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

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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.

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Acknowledgements

We thank Janet Jacobson for editorial assistance.

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Authors and Affiliations

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

    M Hunault-Berger, A Tanguy-Schmidt, P Rachieru, M Truchan-Graczyk, S Francois, M Gardembas-Pain, M Dib, C Foussard & N Ifrah

  2. DBIM and INSERMU444, Hôpital Saint Louis, Paris, France

    V Lévy

  3. Etablissement Français du Sang, Angers, France

    N Piard

  4. Hematology Laboratory, University Hospital, Angers, France

    A Godon

  5. Centre Jean-Bernard, Le Mans, France

    P Solal-Celigny

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  1. M Hunault-Berger
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  2. A Tanguy-Schmidt
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  3. P Rachieru
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  4. V Lévy
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  5. M Truchan-Graczyk
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  6. S Francois
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  7. M Gardembas-Pain
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  8. M Dib
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  9. C Foussard
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  10. N Piard
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  11. A Godon
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  12. P Solal-Celigny
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  13. N Ifrah
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Correspondence to N Ifrah.

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Hunault-Berger, M., Tanguy-Schmidt, A., Rachieru, P. et al. rHuEpo before high-dose therapy allows autologous peripheral stem-cell transplantation without red blood cell transfusion: a pilot study. Bone Marrow Transplant 35, 903–907 (2005). https://doi.org/10.1038/sj.bmt.1704899

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  • DOI: https://doi.org/10.1038/sj.bmt.1704899

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