Broccoli Alessandro, Argnani Lisa, Stefoni Vittorio, Gandolfi Letizia, Zinzani Pier Luigi
Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy.
Hematol Oncol. 2018 Feb;36(1):136-143. doi: 10.1002/hon.2412. Epub 2017 Mar 23.
Epoetin biosimilars are an alternative to originator erythropoietic agents in the treatment of chemotherapy-induced anaemia; however, their effects in patients with lymphoproliferative disorders remain unclear. This analysis examined the response of patients with lymphoproliferative disorders experiencing chemotherapy-induced anaemia to 4- or 8-week treatment with the biosimilar epoetin alpha. Treatment was initiated at first occurrence of haemoglobin (Hb) < 10 g/dL during chemotherapy and was stopped when Hb was >11 g/dL, when chemotherapy was completed, or in case of transfusion dependency. Response to epoetin alpha was defined as an increase in Hb of >1 g/dL or as an Hb > 11 g/dL. Stability was defined as change in Hb of ±1 g/dL, and no response was indicated by a decrease in Hb of >1 g/dL or acquired transfusion dependence. Overall, 65 patients were enrolled (median age 69 years; 47.7% ≥ 70 years old). Mean Hb levels at the initiation of epoetin alpha was 9.3 ± 0.5 g/dL. Mean Hb levels reached 10.7 ± 1.4 and 10.6 ± 1.5 g/dL at weeks 4 and 8, respectively, in patients on first-line chemotherapy and 11.4 ± 1.6 and 9.7 ± 1.3 g/dL in those on a second- or higher-line regimen. Overall, 70.8% of patients responded, 26.1% had stable Hb, and 3.1% did not respond. Delays or interruption of any chemotherapy cycle due to anaemia occurred in 18 patients. The biosimilar epoetin alpha was well tolerated and allowed patients with non-Hodgkin lymphoma or chronic lymphoproliferative disorders to continue their course of chemotherapy by effectively increasing and maintaining adequate concentrations of Hb.
促红细胞生成素生物类似药是治疗化疗所致贫血时替代原研促红细胞生成剂的一种选择;然而,其在淋巴增殖性疾病患者中的疗效仍不明确。本分析研究了发生化疗所致贫血的淋巴增殖性疾病患者接受生物类似药α-促红细胞生成素治疗4周或8周后的反应。治疗在化疗期间血红蛋白(Hb)首次低于10 g/dL时开始,当Hb高于11 g/dL、化疗结束或出现输血依赖时停止。对α-促红细胞生成素的反应定义为Hb升高超过1 g/dL或Hb高于11 g/dL。稳定性定义为Hb变化±1 g/dL,Hb降低超过1 g/dL或出现获得性输血依赖则表明无反应。总体而言,共纳入65例患者(中位年龄69岁;47.7%≥70岁)。开始使用α-促红细胞生成素时的平均Hb水平为9.3±0.5 g/dL。一线化疗患者在第4周和第8周时的平均Hb水平分别达到10.7±1.4和10.6±1.5 g/dL,二线或更高线治疗方案患者的平均Hb水平分别为11.4±1.6和9.7±1.3 g/dL。总体而言,70.8%的患者有反应,26.1%的患者Hb稳定,3.1%的患者无反应。18例患者因贫血导致任何化疗周期延迟或中断。生物类似药α-促红细胞生成素耐受性良好,可使非霍奇金淋巴瘤或慢性淋巴增殖性疾病患者通过有效提高和维持足够的Hb浓度继续进行化疗疗程。