Recombinant human erythropoietin in very elderly patients with myelodysplastic syndromes: results from a retrospective study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-08

AUTHORS

Caterina Tatarelli, Anna Lina Piccioni, Luca Maurillo, Virginia Naso, Roberta Battistini, Mariella D’Andrea, Marianna Criscuolo, Carolina Nobile, Nicoletta Villivà, Stefano Mancini, Benedetta Neri, Massimo Breccia, Susanna Fenu, Francesco Buccisano, Maria Teresa Voso, Roberto Latagliata, Maria Antonietta Aloe Spiriti

ABSTRACT

Myelodysplastic syndromes (MDS) are common in elderly patients. Recombinant human erythro-poietin (rHuEPO) has been widely used to treat anemia in lower risk MDS patients, but few data are known about rHuEPO treatment in the very elderly patient group. In order to investigate the role of rHuEPO treatment in terms of response, overall survival (OS), and toxicity in a very elderly MDS patient group, 93 MDS patients treated with rHuEPO when aged ≥80 years were selected among MDS cases enrolled in a retrospective multicenter study by the cooperative group Gruppo Romano Mielodisplasie (GROM) from Jan 2002 to Dec 2010. At baseline, median age was 82.7 (range 80-99.1) with a median hemoglobin (Hb) level of 9 g/dl (range 6-10.8). The initial dose of rHuEPO was standard (epoetin alpha 40,000 IU/week or epoetin beta 30,000 IU/week) in 59 (63.4 %) patients or high in 34 (36.6 %) (epoetin alpha 80,000 IU/week) patients. We observed an erythroid response (ER) in 59 (63.4 %) patients. No thrombotic event was reported. Independent predictive factors for ER were low transfusion requirement before treatment (p = 0.004), ferritin <200 ng/ml (p = 0.017), Hb >8 g/dl (p = 0.034), and a high-dose rHuEPO treatment (p = 0.032). Median OS from rHuEPO start was 49.3 months (95 % CI 27.5-68.4) in responders versus 30.6 months (95 % CI 7.3-53.8) in resistant patients (p = 0.185). In conclusion, rHuEPO treatment is safe and effective also in the very elderly MDS patients. However, further larger studies are warranted to evaluate if EPO treatment could be worthwhile in terms of quality of life and cost-efficacy in very old patients. More... »

PAGES

1413-1420

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00277-014-2053-9

DOI

http://dx.doi.org/10.1007/s00277-014-2053-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1039788926

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24647684


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