Recombinant Human Erythropoietin for the Prevention and Treatment of Chemotherapy Induced Anemia in Childhood Cancer

Lee, Kun Soo; Lee, Ye Jhin; Kim, Mi Jeong; Choi, Eun Jin

Abstract

PURPOSE: Anemia frequently develops during intensive chemotherapy in childhood cancer patients and requires transfusion. But transfusions are restricted because of many side effects. We prospectively evaluated the efficacy of the recombinant human erythropoietin (rhEPO) in childhood cancer patients who receiving chemotherapy. The safety was also evaluated. METHPDS: rhEPO was administered subcutaneously, 150 U/kg/day, 3 times a week for 12 consecutive weeks in 19 childhood cancer patients from June, 1999 to March, 2000 in the Department of Pediatrics, Kyungpook National University Hospital, Taegu, Korea. The mean age of rhEPO group was 5.2 (1~13) years and the control group was 6.9 (1~13) years. There were 9 hematologic cancers and 10 solid cancers in rhEPO group and there were 17 hematologic cancers and 16 solid cancers in control group. Serum erythropoietin level was measured before treatment and hemoglobin weekly. Packed red cell transfusion was performed in patients with hemoglobin less than 8 g/dL. The safety and adverse reactions (hypertension, headache, facial flushing, redness and pain in injection site, etc) was assessed in rhEPO group. The mean duration of follow up was 24 (6~40) weeks.
RESULTS
The baseline hemoglobin (rhEPO vs control:10.1 vs 10.2 g/dL) and serum erythropoietin levels (rhEPO vs control:182.82 vs 133.92 mU/mL) were similar in two groups. The mean hemoglobin level was statistically higher in rhEPO group (11.4 g/dL) than the control (10.1 g/dL) from 5 weeks after treatment (P=0.025). These statistically different levels were sustained until week 13 (rhEPO vs control: 11.6 vs 10.3 g/dL, P=0.037). The mean transfusion requirements per patient in rhEPO group (4.2 times) were less than control (5.9 times) during the follow up periods, but this was not statistically significant. No serious adverse reactions were observed after the administration of rhEPO.
CONCLUSION
rhEPO is expensive, but is a safe and effective means of increasing hemoglobin level and reducing blood requirements in children with cancer receiving intensive chemotherapy.