Darbepoetin alfa in anemia of myelodysplastic syndromes: present and beyond.
BACKGROUND
Anemia is the leading clinical manifestation in myelodysplastic syndromes (MDS), significantly altering quality of life. Darbepoetin alfa has recently been added to the armentarium of erythropoiesis stimulating agents (ESAs) for the treatment of anemia in MDS.


METHODS
We review here the efficacy and safety data on the use of darbepoetin alfa in the management of anemia in MDS patients. Published reports covering the period from 2005 till today were reviewed, as well as updated guidelines on the use of ESAs.


RESULTS
Darbepoetin alfa administered, during correction phase, once a week or at longer intervals, yielded erythroid response rates comparing favourably with those obtained with recombinant human erythropoietin (rHuEPO) in lower-risk MDS. During maintenance phase, intervals between injections can be further increased in many responders. Quality of life was consistently improved in responders and the drug was overall well tolerated.


CONCLUSIONS
Those results, together with recent studies showing improved long-term outcomes in responders, support the use of darbepoetin, among other ESAs, for the treatment of anemia of lower-risk MDS, as recommended by international guidelines.
Kelaidi
C
C
Service d'Hématologie, Hôpital Avicenne - Université Paris 13, 125, rue de Stalingrad 93000 Bobigny, France.
Fenaux
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P
D000740:Anemia / Q000145:classification / Q000150:complications / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D000068256:Darbepoetin alfa; D004921:Erythropoietin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000150:complications*
D006397:Hematinics; D004921:Erythropoietin; D000068256:Darbepoetin alfa