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An assessment of erythroid response to epoetin α as a single agent versus in combination with granulocyte– or granulocyte-macrophage–colony-stimulating factor in myelodysplastic syndromes using a meta-analysis approach†
Article first published online: 17 JAN 2009
Copyright © 2009 American Cancer Society
Volume 115, Issue 4, pages 706–715, 15 February 2009
How to Cite
Mundle, S., Lefebvre, P., Vekeman, F., Duh, M. S., Rastogi, R. and Moyo, V. (2009), An assessment of erythroid response to epoetin α as a single agent versus in combination with granulocyte– or granulocyte-macrophage–colony-stimulating factor in myelodysplastic syndromes using a meta-analysis approach. Cancer, 115: 706–715. doi: 10.1002/cncr.24090
Presented in part as a poster at the 2007 Annual Meeting of the American Society of Clinical Oncology, Chicago, Illinois, June 1-5, 2007 and at the 49th Annual Meeting and Exposition of the American Society of Hematology, Atlanta, Georgia, December 8-11, 2007.
- Issue published online: 2 FEB 2009
- Article first published online: 17 JAN 2009
- Manuscript Accepted: 12 AUG 2008
- Manuscript Revised: 11 AUG 2008
- Manuscript Received: 18 JUN 2008
- Centocor Ortho Biotech Services, LLC
- myelodysplastic syndromes;
- granuylocyte–colony-stimulating factor;
- granulocyte macrophage–colony-stimulating factor;
Epoetin α (EPO) continues to be the initial treatment of choice for most anemic patients with myelodysplastic syndromes (MDS). Over the years, different therapeutic strategies have been adopted to optimize the clinical benefits of EPO in this setting.
In the current meta-analysis of published literature, erythroid response (ER) rates with EPO as a single agent versus its combination with granulocyte–colony-stimulating factor (G-CSF) or granulocyte-macrophage–colony-stimulating factor (GM-CSF) were compared.
The assessment indicated that the ER rates were comparable between the 2 EPO-based therapeutic strategies. Furthermore, EPO monotherapy at a higher dose of 60,000 to 80,000 U weekly produced significantly higher ER rates (64.5%) compared with the standard oncology dose of 30,000 to 40,000 U weekly either as a single agent (49%; P < .001) or in combination with G-CSF/GM-CSF (50.6% P = .007). In addition, when transfusion-dependent patients were assessed separately, both EPO monotherapy and its combination with G-CSF/GM-CSF produced comparable and appreciable levels of transfusion independence (28.8% and 24.8%, respectively).
In the current meta-analysis, higher doses of EPO demonstrated better ER rates compared with EPO at standard doses alone or in combination with G-CSF/GM-CSF. Furthermore, the authors concluded that prospective clinical studies are warranted to evaluate the use of higher doses of EPO in anemic patients with MDS. Cancer 2009. © 2009 American Cancer Society.