Role of erythropoietin (EPO) in the treatment of late anemia in patients with Chronic Myeloid Leukemia (CML) is still undefined.
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.
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 darbopoietin (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.
Results of EPO treatment for late chronic anemia during long-lasting imatinib therapy are encouraging, with a high rate of response.
- treatment in chronic phase chronic myeloid leukemia