1. ¹Blood Disease Department, University Hospital, Angers, France
2. ²DBIM and INSERMU444, Hôpital Saint Louis, Paris, France
3. ³Etablissement Français du Sang, Angers, France
4. ⁴Hematology Laboratory, University Hospital, Angers, France
5. ⁵Centre Jean-Bernard, Le Mans, France

Correspondence: Professor N Ifrah, Maladies du sang, CHU, 49033 Angers Cedex 01, France. E-mail: noIfrah@chu-angers.fr

Received 1 April 2004; Accepted 1 December 2004; Published online 14 March 2005.

Abstract

To decrease red blood cell (RBC) transfusion requirements during high-dose therapy (HDT) for hematological malignancies, we conducted a pilot study to assess the effect of recombinant human erythropoietin (rHuEpo) given during chemotherapy before HDT and autologous peripheral stem-cell transplantation (APSCT). The transfusion histories of 15 HDT and APSCT for hematological disease performed in 11 consecutive patients who received rHuEpo (10 000 U subcutaneously three times/week) were compared to those of 22 HDT and ASCT performed in 17 consecutive historical controls matched for hematological parameters. rHuEpo increased the hemoglobin (Hb) level from 10.32.3 g/dl at diagnosis to 12.92.2 g/dl at the time of HDT in 11 patients; no major adverse effects occurred. Compared to historical controls (95%, 21/22), RBC transfusion requirements were significantly lower for rHuEpo recipients (26%, 4/15) (P=0.00001) and rHuEpo responders (15%, 2/13) (P=0.000002). After HDT and APSCT, fewer RBC transfusions were needed: 3.3, 1.2 and 0.3 RBC units for controls, rHuEpo recipients and rHuEpo responders, respectively (P=0.006 and 0.00002). Therefore, rHuEpo should be administered before, and not after HDT and APSCT, to lower RBC transfusion requirements after HDT and APSCT.