title: A pilot prospective randomized trial of postoperative epoetin alfa in patients undergoing major operation for upper gastrointestinal malignancy.
abstract: BACKGROUND
  Strategies to reduce red blood transfusion utilization in cancer patients undergoing operation are needed.
  
  
  OBJECTIVE
  Postoperative epoetin alfa (40,000 units subcutaneous on postoperative days 1 and 7) is associated with improved hematologic parameters in patients undergoing major abdominal surgery for malignancy.
  
  
  METHODS
  Prospective, blinded, randomized trial of epoetin alfa (40,000 units subcutaneous on postoperative days 1 and 7) versus placebo in patients undergoing major abdominal operation for malignancy. Primary endpoints were immature reticulocyte fraction, reticulocyte count, and hemoglobin, which were measured on postoperative days 4, 7, and between 14 and 20. Secondary endpoints were transfusions and complications in the 2 groups.
  
  
  RESULTS
  Forty patients were enrolled. There were no significant differences in immature reticulocyte fraction (P = 0.78), reticulocyte count (P = 0.42), or hemoglobin (0.35) in patients randomized to receive epoetin alfa versus placebo. There was no significant difference in red blood cell transfusion rate or postoperative complications in patients who received epoetin alfa compared with placebo.
  
  
  CONCLUSIONS
  The use of postoperative epoetin alfa (40,000 units subcutaneous on postoperative days 1 and 7) in patients undergoing major operation for abdominal or pelvic malignancy is not supported by this randomized trial.
authors.affiliation: Departments of Surgery, University of Florida, Gainesville, FL, USA. Stephen.Grobmyer@surgery.ufl.edu
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Grobmyer
authors.forename: Alan W
authors.initials: AW
authors.lastname: Hemming
authors.forename: Neil
authors.initials: N
authors.lastname: Harris
authors.forename: Kevin
authors.initials: K
authors.lastname: Behrns
authors.forename: Henrietta
authors.initials: H
authors.lastname: Logan
authors.forename: Robin D
authors.initials: RD
authors.lastname: Kim
authors.forename: Myron
authors.initials: M
authors.lastname: Chang
authors.forename: William G
authors.initials: WG
authors.lastname: Cance
authors.forename: Steven N
authors.initials: SN
authors.lastname: Hochwald
mesh_terms: D004311:Double-Blind Method; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D011994:Recombinant Proteins; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa