BACKGROUND:Chemotherapy-related anemia is prevalent among patients with hematologic malignancies. A randomized, open-label, multicenter trial of early versus late epoetin alfa in this population was conducted, focusing on quality of life (QOL). METHODS:Patients with non-Hodgkin lymphoma, Hodgkin lymphoma, chronic lymphocytic leukemia, or multiple myeloma and baseline hemoglobin of 10 to 12 g/dL who were scheduled for > or = 4 months ofmyelosuppressive chemotherapy were randomized to receive < or = 16 weeks of epoetin alfa at a dose of 40,000 U once weekly immediately (early) or to wait and only receive epoetin alfa if hemoglobin decreased to < 9 g/dL (late). Those patients with a hemoglobin level > 12 g/dL after 3 chemotherapy cycles were not randomized. The primary endpoint was a mean change in the Functional Assessment of Cancer Therapy-Anemia (FACT-An) total. RESULTS: In all, 269 patients with a hemoglobin level < or = 12 g/dL were randomized. The mean total FACT-An increased 3.84 (95% confidence interval [95% CI], 0.21-7.46) in early patients and decreased 4.37 (95% CI, -7.99 to -0.74) in late patients (P = .003). Early patients had significantly (P < .05) higher mean scores for total FACT-General; FACT-General physical and functional well-being subscales, total anemia scale, and fatigue subscale; and daily activity, energy, and important activityLinear Analog Scale Assessment scales, as well as reduced bedrest days and restricted activity days. The mean hemoglobin increased 1.2 g/dL (95% CI, 0.98-1.46) in early patients but decreased 0.2 g/dL (95% CI, -0.32-0.12) in late patients (P < .0001). Adverse events were similar between groups (with fatigue being the most prevalent); clinically relevant thromboembolic events were more common in early patients. CONCLUSIONS: Treating mild anemia immediately with epoetin alfa during chemotherapy for hematologic malignancy significantly improved QOL, productivity, and hemoglobin compared with delaying treatment until the hemoglobin level decreases to < 9.0 g/dL. 2006 American Cancer Society
RCT Entities:
BACKGROUND: Chemotherapy-related anemia is prevalent among patients with hematologic malignancies. A randomized, open-label, multicenter trial of early versus late epoetin alfa in this population was conducted, focusing on quality of life (QOL). METHODS:Patients with non-Hodgkin lymphoma, Hodgkin lymphoma, chronic lymphocytic leukemia, or multiple myeloma and baseline hemoglobin of 10 to 12 g/dL who were scheduled for > or = 4 months of myelosuppressive chemotherapy were randomized to receive < or = 16 weeks of epoetin alfa at a dose of 40,000 U once weekly immediately (early) or to wait and only receive epoetin alfa if hemoglobin decreased to < 9 g/dL (late). Those patients with a hemoglobin level > 12 g/dL after 3 chemotherapy cycles were not randomized. The primary endpoint was a mean change in the Functional Assessment of Cancer Therapy-Anemia (FACT-An) total. RESULTS: In all, 269 patients with a hemoglobin level < or = 12 g/dL were randomized. The mean total FACT-An increased 3.84 (95% confidence interval [95% CI], 0.21-7.46) in early patients and decreased 4.37 (95% CI, -7.99 to -0.74) in late patients (P = .003). Early patients had significantly (P < .05) higher mean scores for total FACT-General; FACT-General physical and functional well-being subscales, total anemia scale, and fatigue subscale; and daily activity, energy, and important activity Linear Analog Scale Assessment scales, as well as reduced bedrest days and restricted activity days. The mean hemoglobin increased 1.2 g/dL (95% CI, 0.98-1.46) in early patients but decreased 0.2 g/dL (95% CI, -0.32-0.12) in late patients (P < .0001). Adverse events were similar between groups (with fatigue being the most prevalent); clinically relevant thromboembolic events were more common in early patients. CONCLUSIONS: Treating mild anemia immediately with epoetin alfa during chemotherapy for hematologic malignancy significantly improved QOL, productivity, and hemoglobin compared with delaying treatment until the hemoglobin level decreases to < 9.0 g/dL. 2006 American Cancer Society
Authors: Jean-Luc Canon; Johan Vansteenkiste; Michael Hedenus; Pere Gascon; Carsten Bokemeyer; Heinz Ludwig; Jan Vermorken; Jason Legg; Beatriz Pujol; Ken Bridges Journal: Med Oncol Date: 2011-11-13 Impact factor: 3.064
Authors: Maria E Cabanillas; Hagop Kantarjian; Deborah A Thomas; Gloria N Mattiuzzi; Michael E Rytting; Eduardo Bruera; Lianchun Xiao; B Nebiyou Bekele; Maria C Foudray; Jorge E Cortes Journal: Cancer Date: 2011-07-12 Impact factor: 6.860
Authors: Giacomo Cartenì; Laura Giannetta; Giovanni Ucci; Giorgio De Signoribus; Aldo Vecchione; Graziella Pinotti; Fabio Puglisi; Antonio Contillo; Giuseppe Pezzella; Simona Orecchia; Patrizia Beccaglia Journal: Support Care Cancer Date: 2007-04-13 Impact factor: 3.603
Authors: François Lüthi; Miklos Pless; Serge Leyvraz; Beat Biedermann; Emilie Müller; Richard Hermann; Christian Monnerat Journal: Support Care Cancer Date: 2009-11-17 Impact factor: 3.603
Authors: Julia Bohlius; Kurt Schmidlin; Corinne Brillant; Guido Schwarzer; Sven Trelle; Jerome Seidenfeld; Marcel Zwahlen; Mike J Clarke; Olaf Weingart; Sabine Kluge; Margaret Piper; Maryann Napoli; Dirk Rades; David Steensma; Benjamin Djulbegovic; Martin F Fey; Isabelle Ray-Coquard; Volker Moebus; Gillian Thomas; Michael Untch; Martin Schumacher; Matthias Egger; Andreas Engert Journal: Cochrane Database Syst Rev Date: 2009-07-08
Authors: D Tomlinson; P D Robinson; S Oberoi; D Cataudella; N Culos-Reed; H Davis; N Duong; F Gibson; M Götte; P Hinds; S L Nijhof; P van der Torre; S Cabral; L L Dupuis; L Sung Journal: Curr Oncol Date: 2018-04-30 Impact factor: 3.677