LUXEMBOURG-Home administration of erythropoietin (epoetin alfa,
Epogen, Procrit) safely prevented or delayed the development of
chemotherapy-associated anemia and reduced transfusion requirements
by as much as 35% in a multicenter study of patients with small-cell
lung cancer (SCLC), Nicholas Thatcher, MD, said at the 7th International
Symposium of the Multinational Association of Supportive Care
in Cancer (MASCC).
The 130 participants in this multicen-ter prevention trial from
the Eprex Anemia Prevention Group all had normal hemoglobin levels
prior to their treatment with up to six cycles of intensive, mostly
platinum-based chemotherapy, at 3- to 4-week intervals.
SCLC a Model System
They were randomized to receive no erythropoietin, or erythropoietin
in a dose of 300 or 150 U/kg subcutaneously three times weekly,
starting the day after chemotherapy and continuing until 3 days
before the next chemotherapy cycle.
"We can consider SCLC and its chemotherapy a model system
for exploring the use of erythropoietin," said Dr. Thatcher
of Christie Hospital, Manchester, UK. He told the symposium audience
that even prior to chemotherapy, SCLC patients have significantly
fewer late and early erythroid progenitors in their bone marrow
than do subjects without malignant disease, and are thus especially
vulnerable to anemia.
"By the second, third, fourth, and fifth chemotherapy cycles,"
Dr. Thatcher said, "there was a significant reduction in
the percentage of patients who required transfusions, compared
with the control group," he said.
Transfusions were necessary in 59% of control patients, but in
only 21% of those receiving 300 U/kg of erythropoietin, and in
45% of those on the lower erythropoietin dose.