NoBlood

Bone Marrow Transplant. 2005 Mar 14; [Epub ahead of print]

Nature Publishing Group

rHuEpo before high-dose therapy allows autologous peripheral stem-cell transplantation without red blood cell transfusion: a pilot study.

Hunault-Berger M, Tanguy-Schmidt A, Rachieru P, Levy V, Truchan-Graczyk M, Francois S, Gardembas-Pain M, Dib M, Foussard C, Piard N, Godon A, Solal-Celigny P, Ifrah N.

1Blood Disease Department, University Hospital, Angers, France.

Summary:To decrease red blood cell (RBC) transfusion requirements during high-dose therapy (HDT) for hematological malignancies, we conducted a pilot study to assess the effect of recombinant human erythropoietin (rHuEpo) given during chemotherapy before HDT and autologous peripheral stem-cell transplantation (APSCT). The transfusion histories of 15 HDT and APSCT for hematological disease performed in 11 consecutive patients who received rHuEpo (10 000 U subcutaneously three times/week) were compared to those of 22 HDT and ASCT performed in 17 consecutive historical controls matched for hematological parameters. rHuEpo increased the hemoglobin (Hb) level from 10.3+/-2.3 g/dl at diagnosis to 12.9+/-2.2 g/dl at the time of HDT in 11 patients; no major adverse effects occurred. Compared to historical controls (95%, 21/22), RBC transfusion requirements were significantly lower for rHuEpo recipients (26%, 4/15) (P=0.00001) and rHuEpo responders (15%, 2/13) (P=0.000002). After HDT and APSCT, fewer RBC transfusions were needed: 3.3, 1.2 and 0.3 RBC units for controls, rHuEpo recipients and rHuEpo responders, respectively (P=0.006 and 0.00002). Therefore, rHuEpo should be administered before, and not after HDT and APSCT, to lower RBC transfusion requirements after HDT and APSCT.Bone Marrow Transplantation advance online publication, 14 March 2005; doi:10.1038/sj.bmt.1704899.

PMID: 15765111 [PubMed - as supplied by publisher]