Background:
The response to epoetin-alpha treatment is hard to predict in cancer patients receiving chemotherapy.
Methods:
One hundred and seventeen patients were enrolled in this observational study. they had a hemoglobin (hb) level less than or equal to 10.5 g/dl, were receiving platinum chemotherapy with three cycles pending, and they did not have an iron deficiency or hemolysis. epoetin-alpha was administered subcutaneously three times a week at a dose of 150 iu/kg. ninety patients were examined.
Results:
Response was defined as an increase in hb of at least 2 g/dl during the treatment period. the response rate was 63.3%. the following data were compared between responders and nonresponders at the onset of treatment and after 2 and 4 weeks of epoetin therapy: hb, reticulocytes, serum iron, ferritin, transferrin, transferrin saturation index, and endogenous erythropoietin levels. at baseline, these variables were similar for responders and nonresponders; after 2 weeks, responders showed higher hb (p = 0.001) and transferrin levels (p = 0.042) and reticulocyte counts (p = 0.003); after 4 weeks, only the hb level showed a significant difference (p < 0.0005). changes from baseline in hb level after 2 and 4 weeks correlated significantly (p < 0.01) with response. the change in hb level at week 4 was the best predictor. a change in hb level of less than 0.5 g/dl was associated with a lack of response (predictive power, 71%); a change in hb greater than or equal to 0.5 g/dl was associated with response (predictive power, 89%).
Conclusions:
Response to epoetin-alpha treatment in cancer patients receiving platinum chemotherapy can be predicted from changes in hb level after 4 weeks of therapy.