Once weekly recombinant human erythropoietin treatment for cancer-induced anemia in children with acute lymphoblastic leukemia receiving maintenance chemotherapy: A randomized case-controlled study

Abdelrazik, N.; Fouda, Manal

doi:10.1080/10245330701521572

Cited by 21 publications

(15 citation statements)

References 17 publications

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“…The treatment duration varies between 8 and 28 weeks. Despite the differences in dosage, treatment intervals, and duration for previous studies, a significant increase in Hb levels, a decrease in transfusion rates, and an improvement of QoL have been reported in all studies [9][10][11][12][13][14]. The effect of EPO has been found to be low, and transfusion rates are high in patients receiving platinumbased regimens; these results have been attributed to direct cytotoxic effects on renal cells and a decrease in EPO production.…”

Section: Discussionmentioning

confidence: 58%

Recombinant Human Erythropoietin β: The Effect of Weekly Dosing on Anemia, Quality of Life, and Long-Term Outcomes in Pediatric Cancer Patients

Durmaz

Demirkaya

Sevinir

2011

Pediatric Hematology and Oncology

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Anemia, which is a common problem in cancer patients, has a negative effect on survival by decreasing the efficacy of chemotherapy and particularly of radiotherapy, as well as impairing the quality of life (QoL) of patients. Recombinant human erythropoietin (rHuEPO) decreases a patient's need for transfusions and increases their QoL. The aim of this study was to evaluate the effect of weekly single-dose EPO treatment on transfusion rates, QoL, and hemoglobin (Hb) levels. In addition, patients were followed up for a long period to assess the impact of EPO treatment on survival. The study was conducted from December 2001 to December 2002 in patients with newly diagnosed lymphoma or solid tumors using a prospective and controlled design. EPO-β was given as a single dose of 450 U/kg once a week for 12 weeks. The study and control groups included 16 patients each. Hb levels measured in the study group at the 4th, 8th, and 12th weeks were significantly higher than the values recorded before the start of chemotherapy. In the control group, Hb levels post chemotherapy were significantly lower than values recorded prior to treatment. The increased Hb levels in the study group were significant at the 8th and 12th weeks of treatment compared to levels measured prior to treatment. In the control group, Hb levels at the 4th and 8th weeks were significantly lower than pretreatment levels. When the percent increase of Hb levels of the study and control groups with respect to treatment week was compared, the difference was statistically significant at the 4th, 8th, and 12th weeks. Although the increase on the performance scale within each group during treatment was significant in both the study and control groups, the increase was more marked in the study group. The percent increase on the performance scale with respect to week of treatment was higher in the study group than in the control group. In EPO treatment group, side effects were seen in 38% of patients, with 19% being local pain in the injection area, 13% local hyperemia, and 6% headache. The mean follow-up period of the study and control group was 7.03 ± 0.41 (6.0-7.41) and 7.46 ± 0.45 (6.58-7.83) years, respectively; no statistically significant difference existed between these figures. Overall survival at the end of 7 years of follow-up was 68.8% and 81.3% for the study and control groups, respectively. The use of EPO-β in lymphoma and solid tumor patients on a once-weekly regimen (450 U/kg) was determined to be effective in increasing Hb levels, decreasing transfusion rates, and improving QoL. This regimen was safe, did not cause serious side effects, and can be recommended because of its high patient compliance and tolerability. An effect of EPO on prognosis was not evident. We could not have an explanation on the effect of EPO treatment on prognosis, as there were low number of patients and advanced-staged patients died earlier. Therefore, a larger number of patients are needed to clarify the effect of EPO treatment on prognosis.

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Section: Discussionmentioning

confidence: 58%

Recombinant Human Erythropoietin β: The Effect of Weekly Dosing on Anemia, Quality of Life, and Long-Term Outcomes in Pediatric Cancer Patients

Durmaz

Demirkaya

Sevinir

2011

Pediatric Hematology and Oncology

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“…Front-loaded dosing has been shown to accelerate the hemoglobin response and reduce the need for transfusion [11]. Regular weekly dosing has shown marked efficiency in both adult and pediatric leukemia patients [3,4,10]. Extended dosing schedule (EDS) given every 3 weeks (Q3W) synchronously with chemotherapy cycles in adult patients appears to be similarly efficacious to weekly dosing [3,4,12].…”

Section: Discussionmentioning

confidence: 97%

“…Being a synthetic, chemically modified EPO analogue with a longer half-life and a slower rate of absorption compared to other ESAs [2,5,10], darbepoetin alfa was used in our patients as a single subcutaneous injection of 2.25 ug/kg. Almost 68.5% of our patients receiving darbepoetin required transfusion compared to 92% of the control group.…”

Section: Discussionmentioning

confidence: 99%

Single Dose Darbepoetin Alfa is Useful in Reducing Red Cell Transfusions in Leukemic Children Receiving Chemotherapy

Zachariah

Elshinawy²,

Al‐Rawas

et al. 2013

Pediatric Hematology and Oncology

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The role of erythropoiesis-stimulating agents (ESAs) in the management of chemotherapy-induced anemia (CIA) is becoming increasingly recognized in the field of medical oncology, with paucity of data in pediatrics. We evaluated the efficacy and tolerability of a single-dose darbepoetin alfa, a long-acting ESA, given to 35 pediatric acute lymphoblastic leukemia (ALL) children during induction chemotherapy. Compared to a retrospective control group, the studied patients have required significantly less units of packed red blood cells (0.88 units/patient in the studied group versus 2.04 units in controls), with no major side effects. We recommend further prospective double-blinded studies with more tailored dosing regimens in pediatric ALL cases and solid tumors.

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“…The largest of these trials found no difference overall, but a significant difference in a small subset of patients 5–7 years of age 3. Two much smaller trials of Abdelrazik and Fouda 8 and Csaki et al 11 claimed to show some benefit with the tools they used, but the number of patients in those trials totaled only 30 and 15, respectively, and the smaller one provided no statistical analysis of their findings.…”

Section: Quality Of Life Effectsmentioning

confidence: 98%

Guidelines for Epo use in children with cancer

Feusner¹

2009

Pediatric Blood & Cancer

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Once weekly recombinant human erythropoietin treatment for cancer-induced anemia in children with acute lymphoblastic leukemia receiving maintenance chemotherapy: A randomized case-controlled study

Cited by 21 publications

References 17 publications

Recombinant Human Erythropoietin β: The Effect of Weekly Dosing on Anemia, Quality of Life, and Long-Term Outcomes in Pediatric Cancer Patients

Recombinant Human Erythropoietin β: The Effect of Weekly Dosing on Anemia, Quality of Life, and Long-Term Outcomes in Pediatric Cancer Patients

Single Dose Darbepoetin Alfa is Useful in Reducing Red Cell Transfusions in Leukemic Children Receiving Chemotherapy

Guidelines for Epo use in children with cancer

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