Early epoetin alfa treatment in children with solid tumors.
BACKGROUND
Combination chemotherapy is often used for long periods in children with solid malignancies, leading to anemia and necessitating intervention with red blood cell (RBC) transfusions. Transfusions, however, are associated with a variety of adverse events and risks. Recombinant human erythropoietin (rHuEPO, epoetin alfa) has been shown to reduce the need for transfusions and to ameliorate the symptoms of anemia in adults, but few studies have been conducted thus far in pediatric patients.


METHODS
Thirty-seven children with solid tumors receiving treatment with platinum- or nonplatinum-based chemotherapy were treated with epoetin alfa and supplemental iron in a single-center, open-label, 28-week, case-control study.


RESULTS
Epoetin alfa significantly reduced the need for RBC (P = 0.007) and platelet (P = 0.01) transfusions, and prolonged the time to first RBC transfusion (P = 0.0004) as compared to the control group. Moreover, epoetin alfa was effective in maintaining mean hemoglobin levels during the course of the study, whereas they declined below baseline after week 9 in the control group.


CONCLUSIONS
Epoetin alfa is effective and safe in reducing transfusion requirements and maintaining adequate hemoglobin levels in children with solid tumors undergoing combination chemotherapy.
St. Anna Children's Hospital, Vienna, Austria. zoubek@ccri.univie.ac.at
Andreas
A
Zoubek
Martina
M
Kronberger
D000293:Adolescent; D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage / Q000494:pharmacology*; D006454:Hemoglobins; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D011994:Recombinant Proteins; D016896:Treatment Outcome
D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa