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Treat Anemia Early, Even if Mild, During Blood Cancer Therapy: Presented at ASH

By Roberta Friedman, PhD

SAN DIEGO, CA -- December 10, 2003 -- A randomized trial of epoetin alfa suggests that even mild anemia in cancer patients should be treated - and early - to improve their quality of life.

The findings were reported here December 6^th at the American Society of Hematology (ASH) 45^th Annual Meeting.

The number of days spent in bed or with restricted activity significantly decreased in patients treated early with epoetin. Days in bed decreased by 52.2% and 3.1% by early and late epoetin, and days with restricted activity by 41.6% and 12.2%, respectively (P = .017 for the former comparison, and for the latter, P = .042).

Transfusion rates also decreased with earlier treatment, although missing statistical significance. Early treatment yielded 17.8% of patients needing one or more transfusion of red blood cells, compared to 26.1% of those for whom epoetin treatment was instituted later.

Study investigator David Straus, MD, lymphoma service, Memorial Sloan-Kettering Cancer Center, New York, said, "I think this is the first randomized study to show a benefit in treating mild anemia" and added that the results might be applicable to other conditions causing anemia.

"This is a subset of cancer patients," Dr. Straus said, "but it's provocative."

Guidelines by ASH and American Society of Clinical Oncology suggest treating with epoetin alfa only if hemoglobin levels fall below 10 g/dL during treatment for hematologic malignancies.

The multicenter trial tested the agent for people whose hemoglobin was not that between 10 and 12 g/dL. Half of patients were randomized to epoetin immediately if their level fell into that range, or to later treatment, holding off until their hemoglobin fell below 9 g/dL.

Patients whose hemoglobin level was above 12 g/dL were not randomized until the level decreased to below 12 g/dL.

The 5-year study at 14 sites included 424 enrolled patients, with 153 randomized to early and 134 to late treatment with epoetin.

Cancers responsible for treatment in the trial of epoetin included, lymphomas and leukemias, as well as multiple myeloma.

Ortho funded the study.


[Study title: Early Treatment with Epoetin Alfa Improves Anemia, Quality of Life (QOL), and Productivity in Patients (Pts) with Hematologic Malignancies and Mild Anemia during Chemotherapy (CT). Abstract 1811]

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