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Recombinant human erythropoietin, epoetin beta, in patients with relapsed lymphoma treated with aggressive sequential salvage chemotherapy - results of a randomized trial

Item Type:Article
Title:Recombinant human erythropoietin, epoetin beta, in patients with relapsed lymphoma treated with aggressive sequential salvage chemotherapy - results of a randomized trial
Creators Name:Glossmann, J.P. and Engert, A. and Wassmer, G. and Flechtner, H. and Ko, Y. and Rudolph, C. and Metzner, B. and Doerken, B. and Wiedenmann, S. and Diehl, V. and Josting, A.
Abstract:The aim of the study was to investigate the effects of erythropoietin (epoetin beta) on red blood cell (RBC) transfusions, hemoglobin (Hb) levels, and quality of life (QOL) in patients with relapsed lymphoma treated with an aggressive sequential salvage chemotherapy (SSCT) regimen. Sixty patients with early or late relapsed Hodgkin's disease (n=39) or first relapse of aggressive non-Hodgkin's lymphoma (n=21) were randomized to receive epoetin beta 10,000 IE subcutaneously three times a week or no epoetin during salvage chemotherapy. Patients in both study arms received two cycles of DHAP (dexamethasone, high-dose cytarabine, cisplatin); patients in partial remission (PR) or complete remission (CR) then received cyclophosphamide, followed by peripheral blood stem cell (PBSC) harvest, methotrexate plus vincristine, and etoposide. The final myeloablative course was BEAM (carmustine, etoposide, cytarabine, and melphalan) followed by autologous stem cell support. The primary endpoint of the study was the number of RBC units needed during SSCT. In addition, Hb levels and QOL were measured. The mean number of RBC units given in the epoetin beta arm was 4.5 compared to 8.3 in the control arm (P=0.0134). The mean Hb levels during therapy were 10.4 g/dl in the epoetin beta arm and 9.7 g/dl in the control (P=0.018). From baseline until BEAM therapy QOL (EORTC QLQ C30) and fatigue (MFI) assessment showed little QOL worsening or stable levels in both arms with a steeper increase of fatigue levels in the control group. Patients with relapsed lymphoma undergoing aggressive chemotherapy and stem cell support benefited from epoetin beta therapy, with a decrease of RBC transfusion requirements and lower rise of fatigue levels.
Keywords:Autologous Bone Marrow Transplantation, Anemia, Epoetin beta, Relapsed Lymphoma , Transfusion Requirements
Source:Annals of Hematology
ISSN:0939-5555
Publisher:Springer (Germany)
Volume:82
Number:8
Page Range:469-475
Date:1 August 2003
Official Publication:https://doi.org/10.1007/s00277-003-0695-0
PubMed:View item in PubMed

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