Dose reduction of epoetin-alpha in the prevention of chemotherapy-induced anaemia.

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Serval ID
serval:BIB_2EA885FAEBB0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Dose reduction of epoetin-alpha in the prevention of chemotherapy-induced anaemia.
Journal
Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Author(s)
Lüthi F., Pless M., Leyvraz S., Biedermann B., Müller E., Hermann R., Monnerat C.
ISSN
1433-7339 (Electronic)
ISSN-L
0941-4355
Publication state
Published
Issued date
2010
Volume
18
Number
12
Pages
1515-1520
Language
english
Notes
Publication types: Clinical Trial ; Journal Article
Publication Status: ppublish
Abstract
INTRODUCTION: Anaemia during chemotherapy is often left untreated. Erythropoiesis-stimulating agents are frequently used to treat overt anaemia. Their prophylactic use, however, remains controversial and raises concerns about cost-effectiveness. Therefore, we assessed the efficacy of a dose-reduction schedule in anaemia prophylaxis.
MATERIALS AND METHODS: The study included patients with untreated solid tumours about to receive platinum-based chemotherapy and had haemoglobin (Hb) levels ≥11 g/dL. Epoetin-α was administered at a dose level of 3 × 10,000 U weekly as soon as Hb descended to < 13 g/dL. Dose reductions to 3 × 4,000 U and 3 × 2,000 U weekly were planned in 4-week intervals if Hb stabilised in the range of 11-13 g/dL. Upon ascending to ≥13 g/dL, epoetin was discontinued. Iron supplements of 100 mg intravenous doses were given weekly. Of 37 patients who enrolled, 33 could be evaluated.
RESULTS AND DISCUSSION: Their median Hb level was 13.7 (10.9-16.2) g/dL at baseline and descended to 11.0 (7.4-13.8) g/dL by the end of chemotherapy. Anaemia (Hb < 10 g/dL) was prevented in 24 patients (73%). The mean dose requirement for epoetin-α was 3 × 5,866 U per week per patient, representing a dose reduction of 41%. Treatment failed in nine patients (27%), in part due to epoetin-α resistance in four (12%) and blood transfusion in three (9%) patients.
CONCLUSION: Dose reduction was as effective as fixed doses in anaemia prophylaxis but reduced the amount of prescribed epoetin substantially.
Keywords
Adult, Aged, Anemia/chemically induced, Anemia/prevention & control, Antineoplastic Agents/adverse effects, Antineoplastic Agents/therapeutic use, Dose-Response Relationship, Drug, Erythropoietin/administration & dosage, Female, Hematinics/administration & dosage, Humans, Male, Middle Aged, Neoplasms/blood, Neoplasms/drug therapy, Recombinant Proteins
Pubmed
Web of science
Open Access
Yes
Create date
24/11/2009 8:16
Last modification date
01/10/2019 6:17
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