Quality of life and brain function following high-dose recombinant human erythropoietin in low-risk myelodysplastic syndromes: A preliminary report

Marino Clavio, Flavio Nobili, Enrico Balleari, Nicola Girtler, Filippo Ballerini, Paolo Vitali, Paola Rosati, Claudia Venturino, Riccardo Varaldo, Marco Gobbi, Riccardo Ghio, Guido Rodriguez

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: In this prospective study we evaluate the effects of high-dose recombinant human erythropoietin (rHuEPO) on quality of life (QOL) and brain function in patients with low-risk myelodysplastic syndromes (MDS) (<10% marrow blasts). Preliminary data are reported. Methods: Eleven consecutive patients were given rHuEPO (40 000 IU two times a week) for 12 wk. Responsive patients continued with 40 000 IU/wk for further 12 wk. Changes in QOL were assessed by the Functional Assessment of Cancer Therapy-Anemia (FACT-An) self-report. Neurophysiological evaluation at the start of the therapy (t0) included duplex scanning of neck vessels, transcranial Doppler sonography (TCD), a complex neuropsychological evaluation, and quantitative electroencephalography (qEEG). Eight patients completed the neurophysiological evaluation after 24 wk (t1). Results: Six patients (55%) achieved an erythroid response after 12 wk, which was maintained after 24 wk of treatment. FACT-An score showed a relevant improvement between t0 and t1 in these patients. At baseline, TCD showed a mean cerebral blood flow (CBF) velocity in the upper normal range. Abnormalities in brain function were observed in five patients. In the eight patients who were re-evaluated at t1, improvement was observed in three responding patients, two of them with abnormal values at t0. A strict correlation between QOL and neurophysiological improvements was not observed. Conclusions: A high-dose induction phase with rHuEPO followed by maintenance therapy may be an effective therapeutic schedule for low-risk MDS patients. The erythroid response was associated with positive changes in the QOL. Neurophysiological improvements occurred only in a part (50%) of responding patients, mainly those who showed altered results at baseline.

Original languageEnglish
Pages (from-to)113-120
Number of pages8
JournalEuropean Journal of Haematology
Volume72
Issue number2
DOIs
Publication statusPublished - Feb 2004

Keywords

  • Brain function
  • FACT-An
  • Low-risk MDS
  • Quality of life
  • rHuEpo

ASJC Scopus subject areas

  • Hematology

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