Erythropoietin treatment in chronic phase chronic myeloid leukemia patients treated with frontline imatinib who developed late anemia

Laura Cesini, Camilla Frieri, Claudia Baratè, Federica Sorà, Massimiliano Bonifacio, Marco Cerrano, Antonia Cagnetta, Chiara Elena, Lara Aprile, Nicola Sgherza, Malgorzata Trawinska, Antonella Gozzini, Isabella Capodanno, Monica Crugnola, Ida Carmosino, Emilia Scalzulli, Federica Ricci, Monica Bocchia, Micaela Bergamaschi, Chiara AguzziSimona Sica, Sara Galimberti, Massimo Breccia, Luigiana Luciano, Roberto Latagliata

Research output: Contribution to journalArticle

Abstract

Background: Role of erythropoietin (EPO) in the treatment of late anemia in patients with Chronic Myeloid Leukemia (CML) is still undefined. Methods: Fifty CML patients treated at 14 institutions with frontline imatinib for at least 12 months and in stable complete cytogenetic response who developed a late chronic anemia treated with EPO were retrospectively evaluated. Results: Median time from imatinib start to EPO treatment was 42.2 months [interquartile range (IQR) 20.8-91.9]. Median Hb value at EPO starting time was 9.9 g/dL (IQR 8.9-10.3): Eleven patients (22.0%) were transfusion dependent. Alpha-EPO (40 000 UI weekly) was employed in 37 patients, beta-EPO (30 000 UI weekly) in 9 patients, zeta-EPO (40 000 UI weekly) in 2 patients, and darbepoetin (150 mcg/weekly) in the remaining 2 patients. On the whole, 41 patients (82.0%) achieved an erythroid response, defined as a stable (>3 months) improvement >1.5 g/dL of Hb level, and 9 patients (18.0%) indeed resulted resistant. Among responding patients, 10 relapsed after a median time from EPO start of 20.7 months (IQR 10.8-63.7). No EPO-related toxicity was observed. Conclusions: Results of EPO treatment for late chronic anemia during long-lasting imatinib therapy are encouraging, with a high rate of response.

Original languageEnglish
JournalEuropean Journal of Haematology
DOIs
Publication statusAccepted/In press - Jan 1 2020

Keywords

  • chronic myeloid leukemia
  • erythropoietin
  • imatinib
  • late anemia

ASJC Scopus subject areas

  • Hematology

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    Cesini, L., Frieri, C., Baratè, C., Sorà, F., Bonifacio, M., Cerrano, M., Cagnetta, A., Elena, C., Aprile, L., Sgherza, N., Trawinska, M., Gozzini, A., Capodanno, I., Crugnola, M., Carmosino, I., Scalzulli, E., Ricci, F., Bocchia, M., Bergamaschi, M., ... Latagliata, R. (Accepted/In press). Erythropoietin treatment in chronic phase chronic myeloid leukemia patients treated with frontline imatinib who developed late anemia. European Journal of Haematology. https://doi.org/10.1111/ejh.13436