title: Biosimilar epoetin alfa increases haemoglobin levels and brings cognitive and socio-relational benefits to elderly transfusion-dependent multiple myeloma patients: results from a pilot study.
abstract: Anaemia is a complication reported in up to 70% of the multiple myeloma patients (MM), with remarkable clinical, cognitive and socio-relational consequences. Anaemia relates to the course of MM, normalizing in patients during remission and reappearing in relapsing/non-responding patients. In a pilot study with 31 patients with MM and transfusion-dependent anaemia, we evaluated the effects of Binocrit (biosimilar epoetin alfa) on transfusions, haemoglobin levels, mental status (mini-mental state evaluation) and the patients' social-relational functioning and quality of life (QoL). Within a 12-week interval, patients received 40.000 U Binocrit once a week. Binocrit significantly decreased the incidence of transfusion, regardless of the patients' transfusion history, and significantly increased haemoglobin levels (before-and-after-treatment median haemoglobin values = 8.20 vs. 9.40 g/dl, respectively; Wilcoxon Z test, p < .001). A comparatively greater increment in haemoglobin levels among patients who responded to first vs. additional lines of chemotherapy was also observed. Importantly, we additionally found moderate-to-strong positive associations between increments in haemoglobin levels and corresponding increments both in psychological well-being and QoL (FACT-An scores) and the patients' cognitive status (mini-mental state evaluation scores). After statistically controlling for possible concurrent benefits of anti-myeloma therapy, increments in haemoglobin levels clearly predicted both increments in socio-relational FACT-An scores (Spearman's rho = 0.60, p < .001) and in cognitive functioning scores (Spearman's rho = 0.49, p < .006). Binocrit thus appears as an effective, well-tolerated agent for the management of myeloma anaemia, whose documented benefits include amelioration of anaemia, reduction in transfusion, and improvements in the patients' social-relational functioning and cognitive well-being.
authors.affiliation: Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital Milan, University of Milan, Milan, Italy. roberto.castelli@unimi.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Castelli
authors.affiliation: UniSR-Social.Lab [Research Methods], Faculty of Psychology, San Raffaele University , Milan, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Sciara
authors.affiliation: Fondazione Mattarelli , Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lambertenghi Deliliers
authors.affiliation: UniSR-Social.Lab [Research Methods], Faculty of Psychology, San Raffaele University , Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pantaleo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000209:etiology / Q000628:therapy; D059451:Biosimilar Pharmaceuticals / Q000627:therapeutic use*; D001803:Blood Transfusion; D003071:Cognition; D000068817:Epoetin Alfa / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010865:Pilot Projects; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D059451:Biosimilar Pharmaceuticals; D006454:Hemoglobins; D000068817:Epoetin Alfa
keywords: Anaemia; Biosimilar epoetin α (Binocrit); Cognitive functioning and psychosocial quality of life (QoL); Erythroid-stimulating agents (ESAs); Multiple myeloma