Guidelines for Complications of Cancer Treatment Vol VIII Part B

(rHuEPO) whiles the other received placebo. The treatmentgroup demonstrated significantly improved hemoglobin levels.The Kaplan-Meier survival estimates at 12 months were 60%versus 49% in favor of the intervention group. These results,however, were not significant. Anemia in relation to cancerhas also shown to increase the vascular endothelial factor levelsand also seem to function through induction of cachexia incancer patients. Studies using erythropoietin has shown toimprove quality of life in the treatment as compared to thosewho did not receive the same, a reflection of improvedoxygenation status.Treating Cancer-Related AnemiaWhile simultaneously correction of nutritional deficienciescannot be overemphasized, transfusion of red blood cells and/or the administration of exogenous hematopoietic growthfactors are the simplest way of treating anemia in cancerpatients. Recombinant human erythropoietin (EPO-A)effectively treats anemia by increasing Hemoglobin levels.Three independent open-label, nonrandomized, prospectivestudies, published by clearly demonstrated that EPO increasedHemoglobin by approximately 1.8 g/dL to 2.0 g/dL anddecreased the number of transfusions in more than 7000 cancerpatients receiving cytotoxic chemotherapy. The increase inHemoglobin levels were noted when EPO was administeredat a starting dose of 150 mcg/kg or 10,000 U thrice weekly.In the study by Gabrilove et al involving patients withnonmyeloid malignancies on chemotherapy, a schedule ofonce-weekly EPO (40,000 U) was used [16] . The increase inmean Hemoglobin was 1.8 g/dl in the responders, and thesubsequent reduction in transfusion requirements were similarto those results observed when EPO was given more frequently.The various other studies are summarized in Table 2.483