Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
RECOMBINANT HUMAN ERYTHROPOIETIN (RHUEPO) IS EFFECTIVE IN CORRECTING THE ANEMIA OF MULTIPLE MYELOMA (MM) (MEETING ABSTRACT)
Proc Annu Meet Am Soc Clin Oncol; 11:A1228 1992. Unique Identifier : AIDSLINE ICDB/92681957 Beck JT; Hayden K; Hutchins L; Jagannath S; Barlogie B; Univ. of Arkansas for Medical Sciences, Arkansas Cancer Res.; Center, Little Rock, AR 72205
Abstract:
The anemia associated with MM is a multifactorial process that is poorly characterized. It correlates with the severity of disease and may be related to tumor infiltration of marrow, cytokine production, concurrent cytotoxic therapy, and infection. A decreased erythropoietin (EPO) response to anemia has been reported in patients (pts) with cancer and in those receiving cytotoxic chemotherapy (Miller CB, NEJM 322:1689, 1990), implicating a relative EPO deficiency as contributing to the anemia of cancer. RHuEPO has been effective in correcting the anemia associated with chronic renal failure, rheumatoid arthritis, MM, and AIDS/AZT therapy (Erslev AJ, NEJM 324:1339, 1991). To evaluate the relationships in MM between endogenous EPO, anemia, and the response to rHuEPO, a prospective Phase II trial of rHuEPO was initiated. Inclusion criteria were a diagnosis of MM, stable therapy and stable anemia during the month prior to enrollment, and Hb less than or equal to 10 g/dl. The initial rHuEPO dose was 150 U/kg tiw with 50 U/kg dose escalations once monthly for pts not responding. 14 pts have been entered. The median age is 61 yr (43-75). One pt was excluded due to coexisting, untreated B-12 deficiency. Four pts were receiving VAD therapy. Four were on no therapy post bone marrow transplantation. Three pts were receiving maintenance interferon alpha. One pt was not receiving therapy. One pt was receiving EDAP. Mean pretreatment Hb was 9.2 (7.8-10.0) g/dl and mean EPO was 74 (4-179) U/L. 10/13 pts responded with a mean Hb increased by 3.3 (1.0-7.4) g/dl to a mean value of 12.5 (9.8-17.2) g/dl. All responses occurred with the initial rHuEPO dose of 150 U/kg tiw. Data are presented in a table. RHuEPO is safe and effective in a majority of pts with anemia associated with multiple myeloma. The relatively low serum EPO levels and response to rHuEPO in this group of pts supports the hypothesis that a relative EPO deficiency contributes to the anemia of MM.
Keywords: Adult Aged Anemia/COMPLICATIONS/*THERAPY Antineoplastic Agents, Combined/THERAPEUTIC USE Cisplatin/ADMINISTRATION & DOSAGE Cytarabine/ADMINISTRATION & DOSAGE Dexamethasone/ADMINISTRATION & DOSAGE Doxorubicin/ADMINISTRATION & DOSAGE Erythropoietin/*THERAPEUTIC USE Etoposide/ADMINISTRATION & DOSAGE Hemoglobins/ANALYSIS Human Middle Age Multiple Myeloma/*COMPLICATIONS Recombinant Proteins/THERAPEUTIC USE Vincristine/ADMINISTRATION & DOSAGE CLINICAL TRIAL ABSTRACT
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Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
