Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
ERTHYROPOIETIN THERAPY FOR THE ANEMIA ASSOCIATED WITH AIDS AND AIDS THERAPY AND CANCER
Erythropoietin in Clinical Applications: An International Perspective. Garnick MB, ed. New York, Marcel Dekker, p. 301-24, 1990.. Unique Identifier : AIDSLINE ICDB/91676844 Danna RP; Rudnick SA; Abels RI; The R.W. Johnson Pharmaceutical Res. Inst., Raritan, NJ
Abstract:
AIDS, like other long-term illnesses such as chronic infections, inflammatory diseases, and cancer, frequently is associated with hypoplastic anemia. Often this anemia resembles the anemia of chronic disease. Therapeutic use of recombinant human erythropoietin (rHuEPO) in anemic patients (pts) seeks to replace or augment endogenous EPO, thereby increasing RBC levels. EPO in AIDS and cancer therapy is reviewed, including endogenous EPO levels; mean corpuscular volumes; and rHuEPO in the treatment of pts with anemia associated with chronic renal failure, AIDS, and zidovudine (AZT) therapy (endogenous EPO levels, efficacy, and safety), cancer, and cancer therapy. Overall, studies of rHuEPO administration in chronic renal failure demonstrated that rHuEPO can provide a clinically relevant improvement in the health and perception of well-being of these pts. In the initial study of AZT-treated pts with AIDS, 63 pts who were HIV-positive, with a history of at least one opportunistic infection and a hematocrit of less than or equal to 30%, were enrolled; 29 pts received 100 U/kg of rHuEPO and 34 received placebo, three times a week for up to 3 mo. Most of the pts were white men in their 30s. The cumulative survival rate for all the pts at 6 mo was 84%; at 9 mo, 73%; at 12 mo, 56%; and at 15 mo, 47%. The survival rate in the group of pts receiving rHuEPO did not differ significantly from the rate for pts who received a placebo during the double-blind phase of the study. rHuEPO reduces transfusion requirements and raises hematocrit in HIV-infected pts whose baseline serum endogenous EPO levels are less than 500 mU/ml. Pts whose endogenous EPO levels are greater than 500 mU/ml are less likely to respond to therapy with rHuEPO unless their dose of concomitantly administered AZT is reduced. Preliminary data on anemic cancer pts indicate that rHuEPO can effect an increase in hematocrit in pts treated concomitantly with chemotherapy containing cisplatin, as well as in those pts not receiving aggressive chemotherapy. (28 Refs)
Keywords: Acquired Immunodeficiency Syndrome/BLOOD/*THERAPY Anemia/BLOOD/*THERAPY Anemia, Aplastic/THERAPY Combined Modality Therapy Erythropoiesis/DRUG EFFECTS Erythropoietin/*THERAPEUTIC USE Hematocrit Human Kidney Failure, Chronic/THERAPY Neoplasms/BLOOD/*THERAPY Recombinant Proteins/THERAPEUTIC USE Zidovudine/THERAPEUTIC USE MONOGRAPH REVIEW 912130
M91C4100
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
