The Role of Recombinant Erythropoietin in Childhood Cancer

Shankar, Ananth

doi:10.1634/theoncologist.2007-0126

Cited by 13 publications

(8 citation statements)

References 53 publications

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“…Minimizing blood transfusion to pediatric leukemia patients is a major objective, as it helps in the reduction of transfusion-acquired viral infections, prevents acute transfusion reaction, and abolishes the risk of alloimmunization [1].…”

Section: Discussionmentioning

confidence: 99%

“…It is usually multifactorial and can result from the disease itself (bone marrow infiltration), chemotherapy (bone marrow suppression), or associated infections [1]. Multiple packed red blood cell (PRBC) transfusions are necessary during intensive cycles in induction and/or consolidation chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple packed red blood cell (PRBC) transfusions are necessary during intensive cycles in induction and/or consolidation chemotherapy. PRBC transfusions can be associated with significant risks including blood borne infections, alloimmunization, and longterm iron overload [1,2].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…Recombinant human erythropoietin (rhEPO) was fi rst approved in 1989 for the treatment of anemia associated with chronic kidney disease and subsequently approved for the treatment of chemotherapy-induced anemia in patients with nonmyeloid malignancies. Very limited data exist for pediatric oncology patients and has most recently been summarized by Shankar ( 2008 ) Csáki et al 1998 ;Büyükpamukçu et al 2002 ;Wagner et al 2004 ;Yilmaz et al 2004 ;Razzouk et al 2006 ;Abdelrazik and Fouda 2007 ;Çorapcioglu et al 2008 ;Durmaz et al 2011 ). Darbepoetin has undergone a phase I trial in pediatric patients with chemotherapy-induced anemia but is not approved in this population ).…”

Section: Erythropoietinmentioning

confidence: 99%

Supportive Care in Pediatric Oncology

Feusner¹,

Hastings²,

Agrawal³

2015

Pediatric Oncology

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Each volume of the series "Pediatric Oncology" covers the whole spectrum of the disease concerned, from research issues to clinical management, and is edited by internationally highly respected experts in a comprehensive and clearly structured way. The user-friendly layout allows quick reference to in-depth information. The series is designed for all health-care personnel interested in high-level education in pediatric oncology.

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“…Erythropoietin (EPO) is a 30.4 kDa glycoprotein hormone primarily produced by the fetal liver and adult kidney, which plays an important role in the body such as erythropoiesis, tissueprotective effects, and immune regulatory effects on immune cells (9). The administration of recombinant human erythropoietin (rhEPO) as a key regulator in the production of functional red blood cells is approved to treat the anemia of patients with long-lasting diseases such as cancer and renal failure with clinical bene ts in correcting hemoglobin levels and markedly reduced the required number of blood transfusion and so, patients bene t from advantages, such as improved cardiac function, enhanced exercise capacity, and better QOL (10,11). However, rhEPO administration may cause some adverse effects, including the possibility of host immunity against rhEPO, frequent self-administration by the patients which may not know the correct injection method and high cost (12).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Effects of Genetically Modified Wharton’s Jelly Mesenchymal Stem Cells Expressing Erythropoietin on Cancer-related Anemia in Mice Model

Estiri¹,

Estiri²,

Fallah³

et al. 2020

Preprint

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BackgroundCancer-related anemia (CRA) negatively influences cancer patients’ survival, disease progression, treatment efficacy, and quality of life (QOL). Current treatments such as iron therapy, red cell transfusion, and erythropoietin-stimulating agents (ESAs) may cause severe adverse effects. Therefore, development of long-lasting and curative therapies is highly required. Combined cell and gene therapy platform can introduce a new route for permanent production of erythropoietin (EPO) in the body with various degrees of clinical benefits and avoiding the need for repeat treatments.MethodsIn this study, we developed cell and gene therapy strategy for in-vivo delivery of EPO cDNA via genetic engineering human Wharton’s jelly mesenchymal stem cells (hWJMSCs) to long-term produce and secret human EPO protein after transplantation into the mice model of CRA. To evaluate CRA's treatment in cancer-free and cancerous conditions, at first, we designed recombinant breast cancer cell line 4T1 expressing herpes simplex virus type 1 thymidine kinase (HSV1-TK) by a lentiviral vector encoding HSV1-TK and injected into mice. After 3 weeks, all mice develop the metastatic breast cancer associated to the acute anemia. Then, we administrated ganciclovir (GCV) for 10 days in half of the mice to clear cancer cells. Meanwhile, we designed another lentiviral vector encoding EPO to transduce hWJMSCs. Following implantation of rhWJMSCs-EPO, the whole peripheral blood samples were collected from the tail vein once per week which were immediately analyzed for the measurements of EPO, hemoglobin (Hb), and hematocrit (Hct) plasma levels. Results We found that after implantation of rhWJMSCs-EPO, plasma EPO, Hb, and Hct concentration significantly increased which rose to a peak in the fourth week and remained at a therapeutic level for >17 weeks in the cancer-free group and >10 weeks in the cancerous group.ConclusionOur data indicate that the EPO-transduced hWJMSCs could improve the anemia of cancer in both cancer-free and cancerous mice model. This significant difference in length of time that Hb and Hct are in therapeutic levels in both treatment groups indicates that developing a precise targeted-therapy to eliminate cancer cells along with an effective treatment for CRA, as we presented here, could bring important clinical benefits.

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The Role of Recombinant Erythropoietin in Childhood Cancer

Cited by 13 publications

References 53 publications

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

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

Supportive Care in Pediatric Oncology

Therapeutic Effects of Genetically Modified Wharton’s Jelly Mesenchymal Stem Cells Expressing Erythropoietin on Cancer-related Anemia in Mice Model

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