title: Prospective study of erythropoietin use on quality of life and cost effectiveness in acute myeloid leukemia and allogeneic hematopoietic stem cell transplantation patients.
abstract: BACKGROUND
  Despite frequent anemia and multiple transfusions in patients undergoing chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia , recommendations for use of erythropoiesis-stimulating agents (ESAs) in these populations are still missing. The primary objective was the effect of ESA administration on patient's quality of life (QoL). Secondary objectives were hemoglobin (Hb) recovery, red blood cell (RBC) transfusions, overall survival, and event-free survival.
  
  
  METHODS
  Adult patients with Hb ≤ 11 g/dL after consolidation chemotherapy for acute myeloid leukemia (group 1), or after allo-HSCT for any hematological diseases (group 2), were prospectively included. ESA was administered subcutaneously once per week during a maximum period of 6 months and was stopped when Hb level reached 12 g/dL. A paired-matched analysis using a historical control group was performed for secondary endpoints. Fifty-two patients were included in group 1, and 55 patients were in group 2.
  
  
  RESULTS
  For the global population, a significant improvement of QoL was noticed with ESA use; 83% (group 1) and 71% (group 2) of patients achieved an Hb level ≥ 12 g/dL without transfusion requirement. The pair-matched analysis showed a reduction of 4 RBC units per patient in group 1 (P = .0002) and 3 RBC units per patient in group 2 (P = .04). No significant difference in terms of thromboembolic events, overall survival, and event-free survival was observed between ESA and control groups. A RBC transfusion median savings of €1712 per patient was estimated in each group.
  
  
  CONCLUSIONS
  ESAs have a clinical and economic benefit on Hb recovery, could improve a patient's QoL, and lead to a significant reduction in number of RBC transfusions with no effect on survival.
authors: Blood and Marrow Transplantation Unit, Department of Hematology, Centre Hospitalier Lyon Sud, Pierre Bénite, France. mauricette.michallet@chu-lyon.fr
authors: Mauricette
authors: M
authors: Michallet
authors: Karine
authors: K
authors: Goldet
authors: Mohamad
authors: M
authors: Sobh
authors: Stéphane
authors: S
authors: Morisset
authors: Youcef
authors: Y
authors: Chelghoum
authors: Xavier
authors: X
authors: Thomas
authors: Fiorenza
authors: F
authors: Barraco
authors: Sophie
authors: S
authors: Ducastelle
authors: Hélène
authors: H
authors: Labussière
authors: Catherine
authors: C
authors: Renzullo
authors: Carole
authors: C
authors: Paillet
authors: Christine
authors: C
authors: Pivot
authors: Perrine Badol-Van
authors: PB
authors: Straaten
authors: Angelique
authors: A
authors: Denis
authors: Anne
authors: A
authors: Termoz
authors: Marie
authors: M
authors: Detrait
authors: Franck-Emmanuel
authors: FE
authors: Nicolini
authors: Isabelle
authors: I
authors: Jaisson-Hot
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000191:economics; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000191:economics / Q000401:mortality / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D055815:Young Adult
chemical_list: D004921:Erythropoietin