Erythropoiesis after Therapy with Recombinant Human Erythropoietin: A Dose–Response Study in Anemic Cancer Surgery Patients

Abstract

BACKGROUND AND OBJECTIVES: Preoperative treatment with 600 U/kg of recombinant human erythropoietin (r-HuEPO) effectively increases erythropoiesis in cancer patients. The aim of this study was to evaluate the erythropoietic response after different doses of r-HuEPO in order to find the minimum effective dose. MATERIALS AND METHODS: Twenty anemic sideropenic patients (hemoglobin </=110 g/l; serum iron <600 microg/l) with cancer of the gastrointestinal tract were randomly allocated to two groups: the first (n = 10) received 400 U/kg of r-Hu EPO divided in 4 doses (100 U/kg each, every 4 days); the second (n = 10) received 200 U/kg of r-HuEPO (50 U/kg each, every 4 days). Both groups were given intravenous iron gluconate (125 mg) every day for 15 days. RESULTS: After treatment, the serum iron level significantly rose in both groups. The production of new red blood cells was 176.3+/-90.8 ml in the 200 U/kg group and 268.4+/-79.4 ml in the 400 U/kg group (p = 0.036). The increase of hemoglobin was significantly higher in the 400 U/kg group (22.3+/-2.0 g/l) than in the 200 U/kg group (14.1+/-2.7 g/l) (p = 0.017). CONCLUSION: The r-HuEPO dose of 400 U/kg appears significantly more effective than the 200 U/kg to stimulate erythropoiesis in anemic sideropenic cancer patients.