darbepoietin-alfa after high-dose melphalan and autologous hemopoietic progenitor cell in multiple myeloma patients a pilot studydarbepoietin-alfa后高剂量美法仑和多发性骨髓瘤患者的自体造血祖细胞一个试点研究.pdfVIP

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darbepoietin-alfa after high-dose melphalan and autologous hemopoietic progenitor cell in multiple myeloma patients a pilot studydarbepoietin-alfa后高剂量美法仑和多发性骨髓瘤患者的自体造血祖细胞一个试点研究.pdf

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darbepoietin-alfa after high-dose melphalan and autologous hemopoietic progenitor cell in multiple myeloma patients a pilot studydarbepoietin-alfa后高剂量美法仑和多发性骨髓瘤患者的自体造血祖细胞一个试点研究

Open Journal of Blood Diseases, 2012, 2, 59-65 59 /10.4236/ojbd.2012.23012 Published Online September 2012 (http://www.SciRP.org/journal/ojbd) Darbepoietin-Alfa after High-Dose Melphalan and Autologous Hemopoietic Progenitor Cell in Multiple Myeloma Patients: A Pilot Study Massimo Martino, Ida Callea, Tiziana Moscato, Antonella Pontari, Elisa Spiniello, Roberta Fedele Department of Oncology and Hematology, Azienda Ospedaliera BMM, Reggio Calabria, Italy. Email: maxmartino65@alice.it Received August 3rd, 2012; revised September 4th, 2012; accepted September 12th, 2012 ABSTRACT We describe the effects of Darbepoietin-alfa (Darbe) administration in Multiple Myeloma (MM) after autologous he- mopoietic progenitor cell transplantation (AHPCT). 26 MM patients undergoing AHPCT entered this study. 34 hemo- globin (Hb)-matched patients who had not received recombinant human erythropoietin (Epo) or Darbe and were treated with the same protocol were retrospectively selected for comparative data. Darbe (150 micro g total dose/weekly) was initiating in four weeks after AHPCT, with the aim of achieving an Hb level of ≥11 g/dL. The time to response to Darbe therapy was longer in the patients with Hb 10 g/dL (p = 0.05) and with endogenous Epo levels ≤ 50 mU/ml (p = 0.0098). Hb level on day 60 and 90 after AHPCT, was faster for Darbe recipients (12.5, range 9.4 - 15.4, vs 10.6, range 8.8 - 13.4 g/dL, p = 0.0001, and 13.5, range 12.3 - 14.3, vs 12, range 9.8 - 14 g/dL, respectively, p = 0.0001). The need for Red Blood Cells transfusion, included in the period of 30 - 90 days post-AHPCT was similar (p = ns). This study demonstrates the accelerating effect of Darbe on Hb increase in the setting evaluated and shows that this effect signify- cantly depends on the endogenous Epo level at the start of treatment. The strategy of giving Darbe around 1 month after high-dose melphala