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

L. Cesini, C. Frieri, C. Baratè, F. Sorà, M. Bonifacio, M. Cerrano, A. Cagnetta, C. Elena, L. Aprile, N. Sgherza, M. Trawinska, A. Gozzini, I. Capodanno, M. Crugnola, I. Carmosino, E. Scalzulli, F. Ricci, M. Bocchia, M. Bergamaschi, C. AguzziS. Sica, S. Galimberti, M. Breccia, L. Luciano, R. Latagliata

Research output: Contribution to journalArticlepeer-review


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. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Original languageEnglish
Pages (from-to)286-291
Number of pages6
JournalEur. J. Haematol.
Issue number3
Publication statusPublished - 2020


  • chronic myeloid leukemia
  • erythropoietin
  • imatinib
  • late anemia
  • alpha erythropoietin
  • beta erythropoietin
  • hemoglobin
  • hydroxyurea
  • recombinant erythropoietin
  • unclassified drug
  • zeta erythropoietin
  • adult
  • aged
  • anemia
  • Article
  • blood transfusion
  • clinical article
  • cytogenetics
  • drug safety
  • female
  • human
  • male
  • overall survival
  • priority journal
  • retrospective study
  • treatment duration
  • treatment outcome
  • treatment response


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