Erythropoietin prevents chemotherapy-induced anemia: Case report

Abstract

A thirty-seven year old male patient with heavily pretreated metastatic testicular carcinoma received escalating doses of recombinant human erythropoietin (EPO) before and throughout chemotherapy. Whereas previous chemotherapy regimens repeatedly caused anemic situations in this patient (hemoglobin (HB) 7.0 g/dl requiring multiple transfusions of red blood cells), EPO given as an i.v. bolus injection at escalating doses of 150 to 300 U/kg body weight (BW) twice/week, starting two weeks prior to the identical myelosuppressive treatment protocol, maintained HB at levels above 8.8 g/dl and thus obviated the need for erythrocyte transfusion. EPO was discontinued after 9 weeks of administration when the patient had achieved a hematocrit (HCT) of 41.1% and a HB of 12.7 g/dl. However, erythropoiesis continued to recover for the next 7 weeks reaching a HCT of 42.4% and a HB of 14.3 g/dl, although the next identical chemotherapy cycle had been given within this period. Along with the rise in HB, ferrokinetics changed significantly as measured by serum ferritin, which was reduced to one third at the end of EPO therapy after only 9 weeks (from 979 ng/ml to 320 ng/ml). No side effects due to EPO administration occurred. These data provide first evidence for efficacy of EPO in chemotherapy-induced anemia and may open new avenues for its clinical application.

Clinical application of recombinant human erythropoietin for treatments in patients with head and neck cancer

“…Use of r-hEPO in malignant tumor cases has already been reported by various investigators, including Ludwig et al [9] who tried it in multiple myeloma, Oster et al who used it in non-Hodgkin lymphoma, multiple myeloma [ 14] and testicular tumors, [13] Gebbia et al who used it in cisplatin-treated solid carcinomas [5], Abeis et al [1] (details not known) and Plantanias et al [15] who used it in correction of anemia caused by anticancer chemotherapeutic drug regimens not containing cisplatin. All these reports state the usefulness of r-hEPO.…”

Erythropoietin: Clinical Applications

“…According to preliminary data, rHuEpo administered to patients undergoing chemotherapy can maintain haemoglobin at above 9 g/dl, thus obviating the need for erythro cyte transfusion [87]. In addition to the rise of hae moglobin, a significant reduction of scrum ferritin was observed, a further sign of stimulated crythropoiesis.…”

Response and prediction of response to recombinant human erythropoietin in patients with solid tumors and platinum-associated anemia

“…36 Response of rhEPO therapy in platinumtreated cancer patients rhEPO has been shown to ameliorate the anemia related to BM neoplastic infiltration and multiple myeloma. [42][43][44] In 1990, Oster et al 19 published a case report that contained the first evidence for the efficacy of rhEPO therapy in patients with solid tumors. A male patient with metastatic testicular carcinoma and (cisplatinum-based) chemotherapy-induced anemia was treated with rhEPO injections intravenously (i.v.)…”

“…27 In the multicenter study of Glaspy et al 51 with 2342 enrolled patients, the renal state of the patients was not covered at all. In several publications only vague phrases such as "normal renal parameters" 19,22,25,46 are noted. Some authors use descriptions such as "exclusion of other causes of anemia," 56,57 even if patients with serum creatinine concentrations of Յ2.5 mg/100 mL have been included in the study 7 (Table 1).…”