Erythropoietic growth factors for children with cancer: a systematic review of the literature.
OBJECTIVE
To review evidence on the use of erythropoietic stimulating agents (erythropoietin or darbepoetin) in children with cancer.


METHODS
A systematic review of the published literature was performed using MEDLINE (1966-July 2007) and references from a Cochrane systematic review (focusing mainly on adults) published in 2006.


RESULTS
The review identified 12 studies, comprising five randomized trials, six case control studies and one open-label, dose-escalation study. All the studies that used adequate doses of recombinant human erythropoietin (rhEPO) (usually 150 IU/kg three times per week) demonstrated benefits for rhEPO except for one study in which rhEPO was added to G-CSF in children with high-risk neuroblastoma. Despite the heterogeneity of the populations studied, in terms of age, tumour type and chemotherapy regimen, rhEPO use was associated with consistent benefits in terms of reduced transfusion requirements and improved haematological parameters. Only one case of darbepoietin use was reported.


CONCLUSIONS
While more studies are required, it appears that rhEPO is safe in this vulnerable patient group and can benefit children with cancer by preventing or ameliorating anaemia.
Mystakidou
Kyriaki
K
Department of Radiology, School of Medicine, Areteion Hospital, University of Athens, Athens 115 26, Greece. mistakidou@yahoo.com
Potamianou
Anna
A
Tsilika
Eleni
E
D000740:Anemia / Q000188:drug therapy*; D002648:Child; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D009447:Neuroblastoma / Q000188:drug therapy*; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor