Erythropoietic response induced by recombinant human erythropoietin in anemic cancer patients candidate to major abdominal surgery

Background/Aims: This trial was designed to quantify the production of new red blood cells (RBCs) after treatment with recombinant human erythropoietin (rHuEPO). Materials and Method: Twenty anemic patients with gastric or colorectal cancer were prospectively studied. The control group (n = 10) underwent surgery without delay. The experimental group (n = 10) received treatment with 500 U/kg of r-HuEPO divided in three doses which were administrated as follows: 300 U/kg 12 days before surgery and 100 U/kg 4 and 8 days later. Results: RBC gain was 210 ± 75 mL in the experimental group which received treatment. The erythropoietic response was similar after 300 U/kg (59 ± 36 mL) or 100 U/kg 75 ± 24 mL). No correlation was found between RBC gain and age (r = 0.18) or baseline levels of erythropoietin (r = 0.08), hemoglobin (r = O.O6), erythrocytes (r = 0.01), reticulocytes (r = 0.01), iron (r = 0.28) and ferritin (r = 0.08). One treated patient in the experimental group was transfused with allogeneic blood (2 units) versus 5 control patients (overall 13 units) (p = 0.06). Conclusion: Preoperative treatment with r-HuEPO improved erythropoiesis and reduced allogeneic transfusions in anemic cancer patients. No significant difference in RBC gains was noted between r-HuEPO administration at 300 U/kg and r-HuEPO administration at 100 U/kg. This result suggests a possible dose reduction for future trials.