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Cesini L, Frieri C, Baratè C, Sorà F, Bonifacio M, Cerrano M, Cagnetta A, Elena C, Aprile L, Sgherza N, Trawinska M, Gozzini A, Capodanno I, Crugnola M, Carmosino I, Scalzulli E, Ricci F, Bocchia M, Bergamaschi M, Aguzzi C, Sica S, Galimberti S, Breccia M, Luciano L, Latagliata R. Erythropoietin treatment in chronic phase chronic myeloid leukemia patients treated with frontline imatinib who developed late anemia. Eur J Haematol 2020; 105:286-291. [PMID: 32365249 DOI: 10.1111/ejh.13436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Role of erythropoietin (EPO) in the treatment of late anemia in patients with Chronic Myeloid Leukemia (CML) is still undefined. METHODS Fifty CML patients treated at 14 institutions with frontline imatinib for at least 12 months and in stable complete cytogenetic response who developed a late chronic anemia treated with EPO were retrospectively evaluated. RESULTS Median time from imatinib start to EPO treatment was 42.2 months [interquartile range (IQR) 20.8-91.9]. Median Hb value at EPO starting time was 9.9 g/dL (IQR 8.9-10.3): Eleven patients (22.0%) were transfusion dependent. Alpha-EPO (40 000 UI weekly) was employed in 37 patients, beta-EPO (30 000 UI weekly) in 9 patients, zeta-EPO (40 000 UI weekly) in 2 patients, and darbepoetin (150 mcg/weekly) in the remaining 2 patients. On the whole, 41 patients (82.0%) achieved an erythroid response, defined as a stable (>3 months) improvement >1.5 g/dL of Hb level, and 9 patients (18.0%) indeed resulted resistant. Among responding patients, 10 relapsed after a median time from EPO start of 20.7 months (IQR 10.8-63.7). No EPO-related toxicity was observed. CONCLUSIONS Results of EPO treatment for late chronic anemia during long-lasting imatinib therapy are encouraging, with a high rate of response.
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Affiliation(s)
- Laura Cesini
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
| | - Camilla Frieri
- Hematology, University "Federico II" of Neaples, Naples, Italy
| | - Claudia Baratè
- Department of Clinical and Experimental Medicine - Hematology, University of Pisa, Pisa, Italy
| | - Federica Sorà
- Hematology, Catholic University of Sacred Heart of Rome, Rome, Italy
| | | | - Marco Cerrano
- Department of Oncology and Hematology, University of Turin, Turin, Italy
| | | | | | - Lara Aprile
- Division of Hematology, University of Siena, Siena, Italy
| | - Nicola Sgherza
- Hematology, IRCCS, "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Italy
| | | | | | | | | | - Ida Carmosino
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
| | - Emilia Scalzulli
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
| | - Federica Ricci
- Department of Clinical and Experimental Medicine - Hematology, University of Pisa, Pisa, Italy
| | - Monica Bocchia
- Division of Hematology, University of Siena, Siena, Italy
| | | | - Chiara Aguzzi
- Department of Oncology and Hematology, University of Turin, Turin, Italy
| | - Simona Sica
- Hematology, Catholic University of Sacred Heart of Rome, Rome, Italy
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine - Hematology, University of Pisa, Pisa, Italy
| | - Massimo Breccia
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
| | | | - Roberto Latagliata
- Department of Translational and Precision Medicine, University "La Sapienza" of Rome, Rome, Italy
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