Dose reduction of epoetin-alpha in the prevention of chemotherapy-induced anaemia

摘要: Anaemia during chemotherapy is often left untreated. Erythropoiesis-stimulating agents are frequently used to treat overt anaemia. Their prophylactic use, however, remains controversial and raises concerns about cost-effectiveness. Therefore, we assessed the efficacy of a dose-reduction schedule in anaemia prophylaxis. The study included patients with untreated solid tumours receive platinum-based had haemoglobin (Hb) levels ≥11 g/dL. Epoetin-α was administered at dose level 3 × 10,000 U weekly as soon Hb descended < 13 g/dL. Dose reductions 3 × 4,000 U 3 × 2,000 U were planned 4-week intervals if stabilised range 11–13 g/dL. Upon ascending ≥13 g/dL, epoetin discontinued. Iron supplements 100 mg intravenous doses given weekly. Of 37 who enrolled, 33 could be evaluated. median 13.7 (10.9–16.2) g/dL baseline 11.0 (7.4–13.8) by end chemotherapy. (Hb < 10 g/dL) prevented 24 (73%). mean requirement for epoetin-α 3 × 5,866 U per week patient, representing reduction 41%. Treatment failed nine (27%), part due resistance four (12%) blood transfusion three (9%) patients. effective fixed prophylaxis but reduced amount prescribed substantially.