Results of darbepoetin alfa treatment of anaemia in chemotherapy-receiving early breast cancer patients - one-centre retrospective observational study

ABSTRACT

Goals ESA are recombinant human erythropoietin preparations which stimulate bone marrow to produce RBC. Apart from relieving anaemia symptoms, the application of ESA can prevent the necessity of the red blood cells transfusion in patients with CIA and thus avoid transfusion-related complications. During the Covid-19 pandemic, the absence of the necessity of hospitalization to transfuse blood products presents an additional value. The aim of the study is to assess the results of the application of darbepoetin alfa in the treatment of anaemia in pts undergoing neoadjuvant chemotherapy for EBC. Methods: A retrospective assessmentwas carried out of the results of darbepoetin alfa (Aranesp®) treatment of 98 pts receiving neoadjuvant chemotherapy for EBC in the National Institute of Oncology in Poland in whom therapy was initiated in the period from 02 January 2019 to 16 February 2020. The drug was given to symptomatic anaemia patients, with a haemoglobin (Hb) level of 8–11 g/dL. In addition, it was also applied in chemotherapy-undergoing patients, with asymptomatic anaemia, with a haemoglobin concentration of <8 g/dL. The treatment was continued until a stable Hb level was reached ensuring the security of further oncological treatment without the necessity of RBC transfusion or termination of chemotherapy. Results: The results of darbepoetin alfa treatment were assessed in a group of 98 subsequent pts, in the course of neadjuvant chemotherapy for EBC. The pts received the following chemotherapy regimens AC/PCL (35%), AC/PCL + carboplatin (9%), TCH (33%), TCH-P (8%), other (15%). At the moment of the initiation of ESA administration, 18% pts were aged 65 or more (max 76) while 82% below 65 yrs. of age (min 28). In the majority (90) of pts the number of Aranesp® doses administered did not exceed 3, only 8 received 4 doses. The estimated effectiveness in the <65 vs ≥65 years of age groups was 84.8% vs 79.8%, respectively. The estimated effectiveness values in the following BMI-dependent groups, namely underweight + normal weight (BMI 16–24.99), overweight (BMI 25–29.99) and obesity (BMI 30–43.1), were 86.3%, 76.6% and 72.0%, respectively. Conclusion(s) Darbepoetin alfa proved effective in the treatment of anaemia in chemotherapy-treated pts for EBC. The response to the treatment in the assessed group of pts was 85.7% There were no statistically significant age and BMI-related differences in ESA effectiveness. No significant side effects of darbepoetin alfa therapy were observed. Conflict of Interest No significant relationships.