title: Effects of erythropoiesis-stimulating agents on survival and other outcomes in patients with lymphoproliferative malignancies: a study-level meta-analysis.
abstract: Erythropoiesis-stimulating agents (ESAs) are approved to treat anemia in patients with non-myeloid malignancies receiving myelosuppressive chemotherapy. ESAs reduce transfusion rates, but some clinical studies suggest that ESAs may reduce survival or increase disease progression. This study-level meta-analysis examined the effects of darbepoetin alfa, epoetin alfa or epoetin beta on mortality, disease progression and transfusion incidence in patients with lymphoproliferative malignancies, using randomized, controlled trials of patients receiving chemotherapy and ESAs or standard of care. The odds ratio (OR) for mortality was 1.04 (95% confidence interval [CI], 0.81-1.34, random-effects model, 10 studies); the risk difference was - 0.01 (95% CI, - 0.03-0.02). The OR for disease progression was 1.02 (95% CI 0.81-1.30, random-effects model, five studies). A lower proportion of ESA-treated patients than controls received transfusions (seven studies). In this meta-analysis, ESAs reduced transfusions with no clear effect on mortality or disease progression in patients with lymphoproliferative malignancies receiving chemotherapy.
authors.affiliation: Sundsvall Hospital, Sundsvall, Sweden. michael.hedenus@lvn.se
authors.forename: Michael
authors.initials: M
authors.lastname: Hedenus
authors.forename: Anders
authors.initials: A
authors.lastname: Osterborg
authors.forename: Dianne
authors.initials: D
authors.lastname: Tomita
authors.forename: Chet
authors.initials: C
authors.lastname: Bohac
authors.forename: Bertrand
authors.initials: B
authors.lastname: Coiffier
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data; D018450:Disease Progression; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000188:drug therapy* / Q000401:mortality; D013923:Thromboembolism / Q000209:etiology
chemical_list: D006397:Hematinics