Early Treatment With Red Blood Cell Production Stimulators May Delay Need For Red Blood Cell Transfusions
Published: Sep 22, 2010 1:29 pm
Lower risk myelodysplastic syndromes patients who begin erythropoietin treatment within six months of diagnosis may not need red blood cell transfusions as quickly as patients who begin treatment later, according to a recent study.
Many low-risk myelodysplastic syndromes (MDS) patients experience anemia, or low red blood cell counts. This MDS symptom can cause heart failure and a lower quality of life.
Anemic patients can be treated with red blood cell transfusions. However, frequent transfusions can cause side effects such as excess iron in the blood. MDS patients who are not dependent on transfusions also survive longer than those who are transfusion dependent.
Erythroid stimulating agents (ESA), which increase red blood cell production, can also be used to treat anemia. ESA treatment is most effective in patients who are not yet red blood cell transfusion dependent.
French researchers wanted to determine if using an ESA earlier after diagnosis affected disease outcome.
They retroactively analyzed data from 112 patients newly diagnosed with low or intermediate-1 risk MDS. The patients were not dependent on red blood cell transfusions and began ESA treatment at different times after diagnosis.
Of the patients studied, 30 received 60,000 units weekly of erythropoietin alfa, 39 received 60,000 units of erythropoietin beta, and 43 received 300 µg of Aranesp (darbepoetin alfa). Among these patients, 29 percent did not respond to ESA alone, so they were also given G-CSF, a growth factor that stimulates the bone marrow to produce stem cells.
There was a 63 percent response rate after 12 weeks of ESA treatment. The specific type of ESA and the addition of G-CSF did not significantly influence patient responses.
Patients who began treatment with ESA within six months of being diagnosed had better response rates (76 percent versus 46 percent), responded longer (30 months versus 20 months), and did not require red blood cell transfusions for a significantly longer time (80 months versus 35 months from diagnosis).
After five years, MDS patients who responded to ESA treatment were significantly less likely to progress to acute myeloid leukemia than those who did not respond to treatment (10 percent versus 39 percent). However, the timing of the start of ESA treatment did not significantly impact the risk of progression.
Responders had an overall survival of 73.5 months from the start of ESA treatment versus 42.7 months for non-responding patients. The timing of the start of ESA treatment did not significantly impact survival.
- Aranesp Is A Promising Treatment For Anemic MDS Patients
- Aranesp Reduces Symptoms Of Anemia And Improves Quality Of Life For Myelodysplastic Syndromes Patients
- Red Blood Cell-Stimulating Agents May Improve Survival In Higher-Risk MDS Patients Receiving Vidaza
- Anemia Drugs May Not Increase Risk Of Blood Clots In MDS Patients
- Cell Growth Protein May Predict Lower Risk MDS Patients’ Responses To Red Blood Cell Stimulators