title: [Erythropoietin: a study of its use in oncohematology].
abstract: OBJECTIVE
  To assess the effectiveness of erythropoietin (EPO) in a Clinical Oncohematology Unit within a general hospital, and to propose a therapeutic algorithm with EPO based on recommendations by ASCO.
  
  
  METHODS
  A descriptive, retrospective study was carried out on patients who required support treatment with EPO while in the Oncohematology Unit during the year 2001. Data were collected by reviewing patient medical records. An effective treatment was defined as an increase in baseline hemoglobin (Hb) equal to or higher than 2 g/dL over 4-8 weeks, with no transfusion requirements or decreased transfusion needs. Baseline Hb values, their distribution per diagnosis, and the involvement of platinum-containing chemotherapy regimens were analyzed.
  
  
  RESULTS
  Of the 353 patients in chemotherapy, 87% corresponded to oncologic diagnoses while the rest had hematological neoplasms. A total of 54 patients were assessed, with 83% of these corresponding to the oncologic area. Oncologic diagnoses that most required the use of EPO included: head-neck 53%, genitourinary 39%, and lung 39%. Overall effectiveness was 57% (60% in oncology and 44% in hematology). The Hb value leading to initial prescription (baseline Hb) was always below 10 g/dL for the hematology area, whereas most oncology patients exhibited higher levels at therapy onset.
  
  
  CONCLUSIONS
  1. Its percentage of failure: 40% for oncology and 56% for hematology patients, together with its high cost, shows that a further search for predictive factors is warranted in order to more precisely select individuals who may benefit from this therapy. 2. The percentage of oncology patients with baseline Hb <10 is only 29%. Baseline Hb values for treatment onset and peak Hb values for therapy discontinuation should be agreed upon. Treatment initiation when Hb values fall below 10 g/dL would be a reasonable option, and a decision to use EPO above 10 g/dL should be made in patients with less severe anemia (10-12 g/dL) only if clinical circumstances render it advisable. 3. Use protocols must include clear concept definitions for treatment, and for primary and secondary prophylaxis, which will help in the establishment of therapeutic algorithms.
authors.affiliation: Servicio de Farmacia, Hospital Universitario de Puerto Real, Cádiz. losyesos@yahoo.es
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández Martín
authors.forename: A
authors.initials: A
authors.lastname: Villa Rubio
authors.forename: M
authors.initials: M
authors.lastname: Cameán Fernández
authors.forename: J M
authors.initials: JM
authors.lastname: Borrero Rubio
authors.forename: C
authors.initials: C
authors.lastname: Martínez Díaz
authors.forename: J
authors.initials: J
authors.lastname: Díaz Navarro
authors.forename: F C
authors.initials: FC
authors.lastname: Moreno Sánchez
authors.forename: F J
authors.initials: FJ
authors.lastname: Serrano Ruiz
mesh_terms: D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016527:Drug Costs; D004921:Erythropoietin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006402:Hematologic Diseases / Q000150:complications*; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D006454:Hemoglobins; D009944:Organoplatinum Compounds; D004921:Erythropoietin