Recombinant human erythropoietin (rHuEPO) in the treatment of anemia associated with solid tumors with or without bone marrow infiltration

This study was designed to test the efficacy of rHuEPO in inducing an increase of at least 2 gr/dl over baseline hemoglobin levels in patients affected by solid tumors, with or without bone marrow invasion. The treatment plan consisted of the administration of rHuEPO 150 U/kg of body weight 3 times/week for 6 weeks. In responding patients, a maintenance schedule of 150 U/kg/week was given for a further 6 weeks. Twenty patients with hemoglobin levels of between 8 and 10 gr/dl were treated, 10 of whom (50%) had bone marrow infiltration. There was a significant difference between median baseline serum EPO levels in patients with and without bone marrow invasion (123.5 vs 40 mU/ml, p=0.002). A response was achieved in 10 of the 20 cases (50%), the median duration being 14 weeks (range 3-34+). Three of the 10 patients with bone marrow involvement responded to treatment, as opposed to 7 without bone marrow invasion (30% vs 70%; p=0.179). The treatment was well tolerated and did not give rise to any severe side effects. These data suggest that the rHuEPO 150 U/kg 3 times/wk controls chronic anemia in 50% of patients affected by solid tumors. Good efficacy of rHuEPO treatment was observed in patients without bone marrow infiltration.