title: Epoetin alpha decreases the number of erythrocyte transfusions in patients with acute lymphoblastic leukemia, lymphoblastic lymphoma, and Burkitt leukemia/lymphoma: results of a randomized clinical trial.
abstract: BACKGROUND
  Anemia is an expected consequence of intensive chemotherapy regimens administered to patients with acute leukemia. This study was designed to determine whether epoetin alpha would decrease the number of transfusion events and units of packed erythrocytes (PRBCs) transfused, and the secondary objective was to study the effects of epoetin alpha on quality of life (QOL) and complete remission (CR) rates.
  
  
  METHODS
  Patients with acute lymphoblastic leukemia (ALL), lymphoblastic lymphoma (LL), or Burkitt lymphoma (BL) who were receiving frontline myelosuppressive chemotherapy were randomized to receive epoetin alpha or no epoetin during the first 6 cycles of their planned chemotherapy. QOL was assessed by using the Edmonton Symptom Assessment Scale (ESAS) and the Functional Assessment of Cancer Therapy (FACT)-Anemia questionnaires.
  
  
  RESULTS
  Fifty-five patients were randomized to receive epoetin alpha, and 54 patients received no epoetin. Transfusion data were available for 79 of 81 evaluable patients (98%) who completed the treatment/observation period. The trial was stopped early because of poor accrual before the target of 123 evaluable patients was met. A mean of 10.6 units of PRBCs over 5 months were administered to those who received epoetin alpha compared with 13 units for those who did not receive epoetin (P = .04). There was no significant difference in QOL as assessed by the FACT-Anemia or ESAS instruments. The CR rate and the 3-year CR duration were not affected adversely by use of epoetin alpha.
  
  
  CONCLUSIONS
  Epoetin alpha decreased the number of PRBC transfusions and did not appear to have a negative impact on remission duration. No difference in QOL was observed.
authors.affiliation: Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. mcabani@mdanderson.org
authors.forename: Maria E
authors.initials: ME
authors.lastname: Cabanillas
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Thomas
authors.forename: Gloria N
authors.initials: GN
authors.lastname: Mattiuzzi
authors.forename: Michael E
authors.initials: ME
authors.lastname: Rytting
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
authors.forename: Lianchun
authors.initials: L
authors.lastname: Xiao
authors.forename: B Nebiyou
authors.initials: BN
authors.lastname: Bekele
authors.forename: Maria C
authors.initials: MC
authors.lastname: Foudray
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Cortes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000139:chemically induced / Q000188:drug therapy* / Q000401:mortality; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001803:Blood Transfusion; D002051:Burkitt Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D000068817:Epoetin Alfa; D017707:Erythrocyte Transfusion; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D011788:Quality of Life; D011994:Recombinant Proteins / Q000627:therapeutic use; D012074:Remission Induction; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa