Long-standing resolution of anemia in symptomatic low-grade non-Hodgkin's lymphoma patients treated with recombinant human erythropoietin as sole therapy.

Anemia is a predominant clinical problem in the management of patients with non-Hodgkin's lymphoma and often an indication to initiate chemotherapy. However, many elderly patients, especially those with concomitant disorders, do not tolerate such therapy very well. This report describes three patients with low-grade non-Hodgkin's lymphoma who were treated solely with recombinant human erythropoietin (rhEPO) for lymphoma-associated anemia. The rhEPO was given at an initial dose of 150 U/kg three times weekly, with dose reduction when a response had been achieved. All three patients normalized their hemoglobin level and severe anemia-related symptoms disappeared. Responses are ongoing in two patients after 10 and 12 mo of therapy, respectively. The third patient maintained a response to rhEPO for over 5 yr, without any need for further therapeutic interventions, before dying of an unrelated event. This treatment strategy seems worthy of further investigation in selected lymphoma patients where anemia is the major complication of the disease.