Erythropoietic response induced by recombinant human erythropoietin in anemic cancer patients candidate to major abdominal surgery.
OBJECTIVE
This trial was designed to quantify the production of new red blood cells (RBCs) after treatment with recombinant human erythropoietin (r-HuEPO).


METHODS
Twenty anemic patients with gastric or colorectal cancer were prospectively studied. The control group (n = 10) underwent surgery without delay. The experimental group (n = 10) received treatment with 500 U/kg of r-HuEPO divided in three doses which were administrated as follows: 300 U/kg 12 days before surgery and 100 U/kg 4 and 8 days later.


RESULTS
RBC gain was 210 +/- 75 mL in the experimental group which received treatment. The erythropoietic response was similar after 300 U/kg (59 +/- 36 mL) or 100 U/kg 75 +/- 24 mL). No correlation was found between RBC gain and age (r = 0.18) or baseline levels of erythropoietin (r = 0.08), hemoglobin (r = 0.06), erythrocytes (r = 0.01), reticulocytes (r = 0.01), iron (r = 0.28) and ferritin (r = 0.08). One treated patient in the experimental group was transfused with allogeneic blood (2 units) versus 5 control patients (overall 13 units) (p = 0.06).


CONCLUSIONS
Preoperative treatment with r-HuEPO improved erythropoiesis and reduced allogeneic transfusions in anemic cancer patients. No significant difference in RBC gains was noted between r-HuEPO administration at 300 U/kg and r-HuEPO administration at 100 U/kg. This result suggests a possible dose reduction for future trials.
Braga
M
M
Department of Surgery, Scientific Institute San Raffaele Hospital, University of Milan, Italy.
Gianotti
L
L
Gentilini
O
O
Vignali
A
A
Di Carlo
V
V
D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000150:complications / Q000628:therapy*; D001803:Blood Transfusion; D003362:Cost-Benefit Analysis; D004906:Erythrocyte Count; D004920:Erythropoiesis; D004921:Erythropoietin / Q000097:blood / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D005293:Ferritins / Q000097:blood; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000601:surgery*; D006400:Hematocrit; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron