[Recombinant human erythropoietin in anemia associated with pediatric cancer: study of the identification of predictors of response].
OBJECTIVE
Cancer is frequently associated with anemia and may be related to inadequate erythropoietin production. The objective of this study was to assess the efficacy and safety of recombinant human erythropoietin (r-HuEPO) in increasing hemoglobin levels and reducing the need of blood transfusions in children with cancer, as well as to identify predictors of the response to r-HuEPO.


METHODS
A pilot trial was performed including 25 patients with solid malignant tumors receiving cyclic chemotherapy, r-HuEPO was administered subcutaneously, 150 U/kg/day 5 times a week for 12 consecutive weeks. Response was defined as the achievement of a Hb increase of at least 2 g/dl without blood transfusions. Patients were compared to history matched controls.


RESULTS
Baseline parameters were similar (p > 0.05) in both groups. The mean Hb increase was greater in the r-HuEPO group compared to controls (2.6 vs 0.1 g/dl; p < 0.001) and the mean units of blood transfused were lower in treated patients (0.32 vs 2.36; p < 0.05). Response to r-HuEPO was achieved in 19 (76%) patients. Low baseline erythropoietin levels and an increase in Hb of at least 0.5 g/dl after 3-4 weeks of treatment defined a greater probability of response. No serious adverse effects were observed.


CONCLUSIONS
r-HuEPO treatment represents a safe and effective means of increasing Hb levels and reducing blood requirements in pediatric cancer patients receiving chemotherapy and the prediction of response may be based on baseline serum erythropoietin levels and on the variation of Hb levels after 3-4 weeks of treatment.
Unidad de Oncología Pediátrica, Clínica Universitaria, Facultad de Medicina, Universidad de Navarra, Pamplona.
P
P
León Molinari
M
M
Jiménez Monteagudo
P
P
Barona Zamora
M
M
Riol Diego
L
L
Castro Paz
L
L
Sierrasesúmaga Ariznavarreta
D000293:Adolescent; D000740:Anemia / Q000139:chemically induced* / Q000188:drug therapy*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D018450:Disease Progression; D004921:Erythropoietin / Q000097:blood* / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy; D010865:Pilot Projects; D011379:Prognosis; D011994:Recombinant Proteins; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin