Tandem high‐dose therapy (HDT) for multiple myeloma: recombinant human erythropoietin therapy given between first and second HDT allows second peripheral blood stem cell transplantation without red blood cell transfusion

Summary. We evaluated the ability of recombinant human erythropoietin (rHuEpo) therapy, given before high‐dose therapy (HDT), to allow autologous peripheral blood stem cell transplantation (PBSCT) without red blood cell (RBC) transfusions. Eleven multiple myeloma patients underwent tandem HDT and autologous PBSC, receiving 500 U/kg/week rHuEpo from d 30 after initial transplant. Haemoglobin levels were 9·5 ± 1·1 g/dl and 12·5 ± 0·9 g/dl at the first and second transplant respectively (P < 0·001). RBC transfusions were required for 10/11 patients for the first transplant versus 1/11 for the second (P < 0·001). To conclude, a short course of rHuEpo therapy before HDT facilitates the performance of an autologous transplant without RBC transfusions.

[1]  J. Canon,et al.  Phase III randomized study comparing 5 or 10 μg per kg per day of filgrastim for mobilization of peripheral blood progenitor cells with chemotherapy, followed by intensification and autologous transplantation in patients with nonmyeloid malignancies , 2003, Transfusion.

[2]  F. Baron,et al.  Once weekly recombinant human erythropoietin therapy is very efficient after allogeneic peripheral blood stem cell transplantation when started soon after engraftment. , 2003, Haematologica.

[3]  F. Baron,et al.  Erythropoiesis after nonmyeloablative stem-cell transplantation is not impaired by inadequate erythropoietin production as observed after conventional allogeneic transplantation , 2002, Transplantation.

[4]  F. Baron,et al.  Optimization of recombinant human erythropoietin therapy after allogeneic hematopoietic stem cell transplantation. , 2002, Experimental hematology.

[5]  Y. Beguin Prediction of response and other improvements on the limitations of recombinant human erythropoietin therapy in anemic cancer patients. , 2002, Haematologica.

[6]  Y. Beguin,et al.  Serum soluble transferrin receptor concentration is an accurate estimate of the mass of tissue receptors. , 2001, Experimental hematology.

[7]  P. Pedrazzoli,et al.  Transfusion requirement can be abolished by epoietin-a and autologous platelet predeposit in patients receiving high dose chemotherapy with stem cell support. , 2000, Haematologica.

[8]  M. Kanter,et al.  Transfusion medicine. First of two parts--blood transfusion. , 1999, The New England journal of medicine.

[9]  G. Fillet,et al.  Influence of marrow erythropoietic activity on serum erythropoietin levels after autologous hematopoietic stem cell transplantation. , 1998, Haematologica.

[10]  F. Mandelli,et al.  A controlled trial of recombinant human erythropoietin after bone marrow transplantation. , 1994, Blood.

[11]  G. Fillet,et al.  Quantitative assessment of erythropoiesis and functional classification of anemia based on measurements of serum transferrin receptor and erythropoietin. , 1993, Blood.