Artikel
Safety of anemia-therapy with erythropoietin-alfa during neoadjuvant platin-based chemotherapy for locally advanced esophagogastric adenocarcinoma.
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Veröffentlicht: | 20. März 2006 |
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Background: Reports in the literature indicate that allogeneic blood transfusions are associated with higher perioperative morbidity and a higher recurrence rate in patients with cancers of the gastrointestinal tract. We therefore initiated a study to investigate the role of erythropoietin (EPO) in patients becoming anemic during neoadjuvant chemotherapy.
Methods: Patients with locally advanced (uT3 Nx M0) esophagogastric adenocarcinoma who dropped with their hemoglobin (Hb) level below 12 g/dL during neoadjuvant platin-based chemotherapy received EPO 10.000 IE subcutaneously 3 times per week. Primary objectives were the response rate and safety of therapy with erythropoietin, the need for allogenic red blood cell transfusion and the rate of postoperative complications.
Results: Between 04/03 - 12/04 24 patients (19 males, median age, 62 yrs) were included. 22 patients received EPO and 16 responded (73%). The median increase of the Hb level was 0.9 g/dl. The median Hb level before chemotherapy was 12.2 g/dL (range, 10.3 - 14.9 g/dL) and the median decline of the Hb level was 1.1 g/dL (range, 0 - 4.6 g/dL) before treatment with EPO. A further decline occurred in only 8 patients. Only two patients (8%) received allogenic red blood cell transfusions. Compared to a control group that did not receive EPO the transfusion rate was droped for about 20% and there was also a reduction in the postoperative complications (16% versus 38%).
No EPO-associated adverse events were observed, particularly none of the EPO-treated patients had any thrombotic or embolic cardiovascular event.
Conclusions: Treatment of chemotherapy-induced anemia with EPO in neoadjuvant treated locally advanced esophagogastric adenocarcinomas revealed to be safe and effective.