Erythropoietin for the treatment of anemia of malignancy associated with neoplastic bone marrow infiltration
This clinical trial was performed to study the effects of intravenously (IV) administered recombinant human (rh) erythropoietin (EPO) at escalating doses (150, 300, and 450 U/kg, administered as an IV bolus injection, twice weekly, for 6, 4, and 4 weeks, respectively) in five patients with low-grade...
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Published in | Journal of clinical oncology Vol. 8; no. 6; p. 956 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
01.06.1990
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Abstract | This clinical trial was performed to study the effects of intravenously (IV) administered recombinant human (rh) erythropoietin (EPO) at escalating doses (150, 300, and 450 U/kg, administered as an IV bolus injection, twice weekly, for 6, 4, and 4 weeks, respectively) in five patients with low-grade non-Hodgkin's lymphoma (Ig NHL) and bone marrow involvement and one patient with multiple myeloma (MM). All patients were anemic due to underlying disease. None of the patients had a history of bleeding, hemolysis, renal insufficiency, or other disorders causing anemia in addition to bone marrow infiltrating malignancy. Endogenous EPO serum levels were significantly increased in all patients (74 to 202 mU/mL). Five patients (one MM, four small-cell lymphocytic [SCLC] NHL) showed a dramatic increase of hemoglobin (Hb), hematocrit (Hk) and RBC count becoming obvious on the second EPO dose level. Initial ferritin serum values, which were high mostly due to polytransfusion, were significantly reduced in responding patients. Erythropoiesis of one patient with extensive follicular mixed (fm) NHL did not respond to EPO treatment. Platelet (PLT) count increase (greater than 75% above starting levels) during and following EPO therapy was observed in one patient with MM. Adverse events due to EPO therapy have not been recorded. These findings point out a previously unrecognized capacity of EPO given at pharmacologic doses to stimulate erythropoiesis in patients with anemia due to bone marrow infiltration by neoplastic lymphocytes in spite of enhanced endogenous EPO expression. |
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AbstractList | This clinical trial was performed to study the effects of intravenously (IV) administered recombinant human (rh) erythropoietin (EPO) at escalating doses (150, 300, and 450 U/kg, administered as an IV bolus injection, twice weekly, for 6, 4, and 4 weeks, respectively) in five patients with low-grade non-Hodgkin's lymphoma (Ig NHL) and bone marrow involvement and one patient with multiple myeloma (MM). All patients were anemic due to underlying disease. None of the patients had a history of bleeding, hemolysis, renal insufficiency, or other disorders causing anemia in addition to bone marrow infiltrating malignancy. Endogenous EPO serum levels were significantly increased in all patients (74 to 202 mU/mL). Five patients (one MM, four small-cell lymphocytic [SCLC] NHL) showed a dramatic increase of hemoglobin (Hb), hematocrit (Hk) and RBC count becoming obvious on the second EPO dose level. Initial ferritin serum values, which were high mostly due to polytransfusion, were significantly reduced in responding patients. Erythropoiesis of one patient with extensive follicular mixed (fm) NHL did not respond to EPO treatment. Platelet (PLT) count increase (greater than 75% above starting levels) during and following EPO therapy was observed in one patient with MM. Adverse events due to EPO therapy have not been recorded. These findings point out a previously unrecognized capacity of EPO given at pharmacologic doses to stimulate erythropoiesis in patients with anemia due to bone marrow infiltration by neoplastic lymphocytes in spite of enhanced endogenous EPO expression. |
Author | Zeile, G Brune, T Kraemer, H P Herrmann, F Gamm, H Oster, W Mertelsmann, R Müller, G Lindemann, A |
Author_xml | – sequence: 1 givenname: W surname: Oster fullname: Oster, W organization: Department of Hematology, Johannes Gutenberg-University, Mainz, Federal Republic of Germany – sequence: 2 givenname: F surname: Herrmann fullname: Herrmann, F – sequence: 3 givenname: H surname: Gamm fullname: Gamm, H – sequence: 4 givenname: G surname: Zeile fullname: Zeile, G – sequence: 5 givenname: A surname: Lindemann fullname: Lindemann, A – sequence: 6 givenname: G surname: Müller fullname: Müller, G – sequence: 7 givenname: T surname: Brune fullname: Brune, T – sequence: 8 givenname: H P surname: Kraemer fullname: Kraemer, H P – sequence: 9 givenname: R surname: Mertelsmann fullname: Mertelsmann, R |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/2189957$$D View this record in MEDLINE/PubMed |
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SubjectTerms | Aged Anemia - drug therapy Anemia - etiology Blood Coagulation - physiology Bone Marrow - pathology Clinical Trials as Topic Erythropoiesis - drug effects Erythropoietin - adverse effects Erythropoietin - blood Erythropoietin - therapeutic use Female Ferritins - blood Hematopoiesis - drug effects Humans Kinetics Male Middle Aged Neoplasms - complications Neoplasms - drug therapy Neoplasms - pathology Tumor Necrosis Factor-alpha - analysis |
Title | Erythropoietin for the treatment of anemia of malignancy associated with neoplastic bone marrow infiltration |
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