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Impact of a new dosing regimen of epoetin alfa on quality of life and anemia in patients with low-risk myelodysplastic syndrome

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Abstract

This study evaluated the impact of a new epoetin alfa dosing regimen on quality of life (QOL), transfusion requirements, and hemoglobin (Hb) levels in 133 patients with low-risk myelodysplastic syndrome (MDS) and Hb ≤10 g/dl. Epoetin alfa 40,000 IU was given subcutaneously twice weekly; after 4 weeks, the dose could be reduced to 40,000 IU weekly in patients achieving erythroid response. QOL was assessed using the functional assessment of cancer therapy-anemia (FACT-An) questionnaire. FACT-An scores increased on average by 7.5 after 4 weeks and by 8.8 after 8 weeks compared with baseline. FACT-An scores were positively associated with Hb values (r=0.53, P<0.01). The mean FACT-An score increase at week 8 was 10.2 in responders and 5.6 in nonresponders. The overall erythroid response rate at week 8 was 68%: 74% in transfusion-independent patients and 59% in transfusion-dependent patients. Of all responders at week 8, response was maintained in 86% at week 12, 71% at week 16, 65% at week 20, and 54% at week 24. Treatment was generally well tolerated. Our data provide new and encouraging results regarding the benefits of 40,000 IU biweekly induction doses followed by 40,000 IU weekly in improving QOL, correcting anemia, and reducing transfusion requirements in low-risk MDS patients.

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Authors and Affiliations

  1. II Facoltà di Medicina e Chirurgia, Università di Roma La Sapienza-Azienda Ospedaliera Sant’Andrea, Rome, Italy

    M. A. Aloe Spiriti & B. Monarca

  2. Divisione Ematologia, Cattedra di Ematologia, Rome, Italy

    R. Latagliata

  3. Divisione Ematologia, Ospedale di Montefiascone, Montefiascone, VT, Italy

    P. Niscola

  4. Dipartimento di Ematologia Padiglione Marcora, Policlinico di Milano, Milan, Italy

    A. Cortelezzi

  5. Divisione Ematologia, Ospedale S. Sebastiano Martire, Frascati (Rome), Italy

    M. Francesconi

  6. Ospedale “C. Cantù” Reparto di Medicina Unità Operativa di Ematologia, Abbiategrasso, MI, Italy

    D. Ferrari

  7. Divisione Ematologia, Azienda Ospedaliera S. Giuseppe Moscati, Avellino, Italy

    E. Volpe

  8. Clinica Ematologia DIMI Università di Genova Ospedale S. Martino, Genoa, Italy

    M. Clavio

  9. Azienda Ospedaliera Careggi, Ematologia, Florence, Italy

    A. Grossi

  10. Azienda Unità Sanitaria N.6 Ospedale Civico G. Giglio, Servizio Assistenza Ematologia e Oncologia, Cefalu, PA, Italy

    M. Tambone Reyes

  11. IRCCS “Casa del Sollievo della Sofferenza” Divisione Ematologia, S. Giovanni, Rotondo, FG, Italy

    P. Musto

  12. Divisione di Ematologia con TMO, Policlinico Universitario “P. Giaccone”, Palermo, Italy

    M. E. Mitra

  13. U.O. di Ematologia, Università di Pisa Ospedale S. Chiara, Pisa, Italy

    A. Azzarà

  14. Divisione Ematologia, Ospedale San Felice a Cancello, Caserta, Italy

    D. Pagnini

  15. Azienda Ospedaliera S. Giovanni di Dio e Ruggi d’Aragona, U.O. di Ematologia, Salerno, Italy

    G. D’Arena

  16. Divisione di Ematologia, Ospedale Civile dello Spirito Santo, Pescara, Italy

    A. Spadano

  17. Divisione Ematologia, Dipartimento di Medicina Università di Genova, Genoa, Italy

    E. Balleari

  18. Ospedale Maggiore, II Medica Servizio Ematologia, Trieste, Italy

    P. Pecorari

  19. Dipartimento Oncologia Servizio Ematologia, Ospedale di Livorno, Livorno, Italy

    E. Capochiani

  20. Centro Malattie del Sangue, Ospedale Castelfranco Veneto, Treviso, Italy

    E. De Biasi

  21. Divisione Medicina, Ospedale di Desio, Desio, MI, Italy

    D. Perego

  22. Divisione Ematologia, Istituto Regina Elena—IFO, Viale E. Chianesi 53, 00128, Rome, Italy

    F. Pisani & M. C. Petti

  23. Divisione Ematologia , Ospedale San Polo, Monfalcone, GO, Italy

    G. Scaramella

Authors
  1. M. A. Aloe Spiriti
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  2. R. Latagliata
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  3. P. Niscola
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  4. A. Cortelezzi
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  5. M. Francesconi
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  6. D. Ferrari
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  7. E. Volpe
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  8. M. Clavio
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  11. P. Musto
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  12. M. E. Mitra
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  13. A. Azzarà
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  25. M. C. Petti
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Correspondence to M. C. Petti.

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Spiriti, M.A.A., Latagliata, R., Niscola, P. et al. Impact of a new dosing regimen of epoetin alfa on quality of life and anemia in patients with low-risk myelodysplastic syndrome. Ann Hematol 84, 167–176 (2005). https://doi.org/10.1007/s00277-004-0961-9

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