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The effectiveness and tolerability of epoetin alfa in patients with multiple myeloma refractory to chemotherapy

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International Journal of Clinical and Laboratory Research

Abstract

Anemia is a frequent complication of multiple myeloma, becoming chronic in patients who are resistant to chemotherapy. This randomized, parallel, controlled multicenter study (71 patients receiving concomitant chemotherapy) evaluated the efficacy and safety of epoetin alfa in improving anemia and eliminating the need for transfusions in multiple myeloma patients refractory to conventional first- or second-line chemotherapy. Forty patients were treated with subcutaneous epoetin alfa (150 IU/kg per dose, increasing to 300 IU/kg per dose, every 3 weeks) for 6 months, and 31 entered a control group. The epoetin alfa group had a significantly (P≤0.001) greater percentage of patients (75% vs. 21%) with increases in hemoglobin levels and/or reduced transfusion requirements. In 44 non pre-transfused patients (20 controls, 24 in the epoetin alfa group), the mean increase in hemoglobin was significantly (P≤0.0001) greater in the epoetin alfa group (+2.1 vs. −0.2 g/dl). Increases in hematocrit and red blood cells were also significantly (P≤0.0001) greater in epoetin alfa-treated patients, with corresponding reductions in transfusion requirement. In the 27 pre-transfused patients (11 controls, 16 in the epoetin alfa group), there was a trend towards reduced transfusional need in epoetin alfa-treated patients. Thus, in patients with multiple myeloma refractory to chemotherapy epoetin alfa is a well-tolerated treatment which improves anemia in non pre-transfused patients and appears to reduce transfusion need in those previously transfused.

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Authors and Affiliations

  1. Department of Biomedical Sciences and Human Oncology, University of Bari, Section of Internal Medicine, P.za G. Cesare 11, I-70124, Bari, Italy

    F. Dammacco & F. Silvestris

  2. Hematology Institute, Arcispedale S. Anna, Ferrara, Italy

    G. L. Castoldi

  3. Hematology Division, Ospedale S. Chiara, Pisa, Italy

    B. Grassi

  4. Hematology Division, IRCCS Policlinico S. Matteo, Pavia, Italy

    C. Bernasconi

  5. Department of Hematology, University of Verona, Verona, Italy

    G. Nadali & G. Perona

  6. Hematology Division, Ospedale S. Camillo, Rome, Italy

    A. De Laurenzi

  7. Clinica Medica II, University of Modena, Modena, Italy

    U. Torelli

  8. Clinica Medica II, Policlinico S. Matteo, Pavia, Italy

    E. Ascari

  9. Hematology Division, Policlinico Careggi, Florence, Italy

    P. L. Rossi Ferrini

  10. Department of Biomedical Sciences and Human Oncology, University of Torino, Clinical Section, Turin, Italy

    F. Caligaris-Cappio

  11. Hematology Division, Ospedale ‘Le Molinette’, Turin, Italy

    A. Pileri & L. Resegotti

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  1. F. Dammacco
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  2. F. Silvestris
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  3. G. L. Castoldi
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  4. B. Grassi
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  5. C. Bernasconi
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  6. G. Nadali
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  7. G. Perona
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  8. A. De Laurenzi
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  9. U. Torelli
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  10. E. Ascari
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  11. P. L. Rossi Ferrini
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  12. F. Caligaris-Cappio
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  13. A. Pileri
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  14. L. Resegotti
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Dammacco, F., Silvestris, F., Castoldi, G.L. et al. The effectiveness and tolerability of epoetin alfa in patients with multiple myeloma refractory to chemotherapy. Int J Clin Lab Res 28, 127–134 (1998). https://doi.org/10.1007/s005990050032

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  • DOI: https://doi.org/10.1007/s005990050032

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