title: Evaluation of hypochromic erythrocytes in combination with sTfR-F index for predicting response to r-HuEPO in anemic patients with multiple myeloma.
abstract: The purpose of this study was to evaluate the sTfR-F index and hypochromic erythrocytes (HYPO%) as potential predictors of response to recombinant human erythropoietin (r-HuEPO) of anemic patients with multiple myeloma (MM) before treatment, as well as early in the course of treatment. Twenty-six newly diagnosed anemic MM patients received r-HuEPO 30,000 IU/wk sc, for six weeks. The sTfR-F index and HYPO% were determined at baseline and at weeks 2 and 6. Patients were classified in 1 of 4 categories of a diagnostic plot, according to erythropoietic state (ES I-IV), defined by the combination of sTfR-F index and HYPO%. Sixteen of 20 patients in ES I and II before treatment responded to r-HuEPO, whereas none of the 6 patients in ES III and IV responded (P < .001). At week 2, 44% of patients who responded and 60% of the nonresponders were in functional iron deficiency (FID) and the proportion increased to 69% and 80%, respectively, by week 6. Seven of the patients who did not respond received in addition 200 mg iron sucrose IV weekly, for the next 4 weeks, and 6 of them responded. These results suggest that combination of sTfR-F index and HYPO% in a diagnostic plot can be used as a predictive model to recognize patients who will benefit from r-HuEPO and identify FID requiring iron supplementation, before treatment and early in the course of treatment, contributing thus to optimization of r-HuEPO therapy.
authors.affiliation: Department of Hematology, Papageorgiou General Hospital, Thessaloniki, Greece. ikatodritou@otenet.gr
authors.forename: Eirini
authors.initials: E
authors.lastname: Katodritou
authors.forename: Matthaios
authors.initials: M
authors.lastname: Speletas
authors.forename: Kostas
authors.initials: K
authors.lastname: Zervas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kapetanos
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Georgiou
authors.forename: Anna
authors.initials: A
authors.lastname: Christoforidou
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Pavlitou
authors.forename: Michael
authors.initials: M
authors.lastname: Sion
authors.forename: John
authors.initials: J
authors.lastname: Christakis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000747:Anemia, Hypochromic / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D004906:Erythrocyte Count / Q000379:methods; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009101:Multiple Myeloma / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D011994:Recombinant Proteins
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin