title: Interaction of psychological factors and the effect of epoetin-alfa treatment in cancer patients on hemoglobin and fatigue.
abstract: BACKGROUND
  Epoetin alpha is known to produce a hematological response in anemic cancer patients. A concomitant reduction in fatigue as well as an improvement of depression and anxiety and of quality of life has been reported. However, these effects are discussed controversially. Psychological variables may have a moderating effect on fatigue reduction.
  
  
  METHODS
  Fifty-four anemic cancer outpatients were treated with epoetin alpha over 26 weeks with an initial dose of 3 x 10,000 IU/week and further individually adapted dosage. Hemoglobin level, fatigue, depression, anxiety, and health-related quality of life were measured every 4 weeks.
  
  
  RESULTS
  The hematological response rate was 50%, with 1/3 occurring after more than 8 weeks of treatment. Fatigue, depression, and quality of life improved significantly. Reduction in fatigue was associated with response, but the correlations between fatigue and hemoglobin were weak. Less depression and higher quality of life before treatment correlated with a better fatigue reduction when controlling for hemoglobin increase and initial fatigue level.
  
  
  CONCLUSIONS
  Psychological variables influence the reduction of fatigue during therapy with epoetin alpha in anemic cancer patients and should therefore be assessed at the beginning of treatment.
authors.affiliation: Clinic for Psychosomatics, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany. franziska.geiser@ukb.uni-bonn.de
authors.forename: Franziska
authors.initials: F
authors.lastname: Geiser
authors.forename: Corinna
authors.initials: C
authors.lastname: Hahn
authors.forename: Rupert
authors.initials: R
authors.lastname: Conrad
authors.forename: Reinhard
authors.initials: R
authors.lastname: Liedtke
authors.forename: Tilman
authors.initials: T
authors.lastname: Sauerbruch
authors.forename: Ingo
authors.initials: I
authors.lastname: Schmidt-Wolf
authors.forename: Axel
authors.initials: A
authors.lastname: Glasmacher
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D001007:Anxiety / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003863:Depression / Q000209:etiology; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D005221:Fatigue / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D005260:Female; D005858:Germany; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications / Q000523:psychology*; D011237:Predictive Value of Tests; D011584:Psychology; D011788:Quality of Life; D011994:Recombinant Proteins; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa