Iron absorption during epoetin alfa therapy for chemotherapy-associated anaemia.

Absorption of a physiological dose of ferrous iron was studied in 18 patients with solid malignancy receiving epoetin therapy for mild chemotherapy-associated anemia. The historical control group consisted of 25 iron replete volunteers (iron absorption 20 +/- 11% in males and 26 +/- 13% in females) and 21 patients with uncomplicated iron deficiency (iron absorption 71 +/- 19%). Iron absorption was increased in the majority of the cancer patients (iron absorption 59 +/- 35%). There were no significant differences in iron absorption between cancer patients who were iron replete or iron deficient according to current clinical practice guidelines (iron deficiency: transferrin saturation < 20% and/or serum ferritin < 100 ng/mL). Red cell iron incorporation was not disturbed in the majority (89%) of patients.

Effects of early intervention with epoetin alfa on transfusion requirement, hemoglobin level and survival during platinum-based chemotherapy: Results of a multicenter randomised controlled trial.

This work was conducted to evaluate the effect of early intervention with epoetin alfa (EPO) on transfusion requirements, hemoglobin level (Hb), quality of life (QOL) and to explore a possible relationship between the use of EPO and survival, in patients with solid tumors receiving platinum-based chemotherapy. Three hundred and sixteen patients with Hb12.1g/dL were randomised 2:1 to EPO 10000 IU thrice weekly subcutaneously (n = 211) or best supportive care (BSC) (n = 105). The primary end point was proportion of patients transfused while secondary end points were changes in Hb and QOL. The protocol was amended before the first patient was recruited to also prospectively collect survival data. EPO therapy significantly decreased transfusion requirements (P < 0.001) and increased Hb (P < 0.005). EPO-treated patients had significantly improved QOL compared with BSC patients (P < 0.05). Kaplan-Meier estimates showed no differences in 12-month survival (P = 0.39), despite a significantly greater number of patients with metastatic disease in the EPO group (78% vs. 61%, P = 0.001). EPO was well tolerated. This study has shown that early intervention with EPO can result in a significant reduction of transfusion requirements and increases in Hb and QOL in patients with mild anemia during platinum-based chemotherapy.

[Decline in the need for blood transfusions in cancer patients due to the use of epoietin alfa during cisplatin based chemotherapy]. / Afname van de transfusiebehoefte bij oncologiepatiënten door het gebruik van epoëtine tijdens cisplatinebevattende chemotherapie.

OBJECTIVE: To compare the need for blood transfusions between two groups of patients treated with cisplatin-containing chemotherapy. One of these groups received epoetin alpha therapy. DESIGN: Prospective with an historical control group. METHODS: From April 1998 to December 1999, 44 patients who were being treated with cisplatin and gemcitabine were also administered epoetin alpha (10,000 U subcutaneously, thrice weekly) from the onset of anaemia. The need for red blood cell transfusions in this group was compared to a historical control group of 46 patients treated with the same combination chemotherapy regimen from November 1995 to July 1997. RESULTS: In the historical control group, each patient received an average of 1.6 red blood cell transfusions as compared to 0.7 in the epoetin alpha group (a 58% reduction). The average number of units of red blood cells transfused per patient was 3.6 for the control group and 1.8 for the epoetin alpha group (a 50% reduction). In the epoetin alpha group, none of the patients received more than 2 transfusions whereas in the control group, 10 patients (22%) received 3 or more transfusions. In two patients, epoetin therapy had to be stopped due to the occurrence of hypertension. CONCLUSION: Epoetin alpha reduced the need for red blood cell transfusions during cisplatin-containing chemotherapy. Its toxic effect was minimal.

The effect of p53-function on the sensitivity to paclitaxel with or without hyperthermia in human colorectal carcinoma cells.

The importance of p53-function for the sensitivity to paclitaxel with and without hyperthermia (HT) was studied in an isogenic cell line system. The inactivation of p53 decreased sensitivity to paclitaxel (1.1-2.5-fold), which correlated with a lower induction of apoptosis. The magnitude of the G2/M arrest after treatment with paclitaxel was similar in all cell lines. The cytotoxicity of paclitaxel was not enhanced by HT in either wild-type p53 or p53-inactivated cells. In conclusion, cellular sensitivity to paclitaxel depends on p53-function by its ability to induce apoptosis. Irrespective of the p53-function HT was not able to enhance the sensitivity to paclitaxel.