The influence of erythropoietin on cognitive function in women following chemotherapy for breast cancer



Objective: Cognitive dysfunction is a potential side effect of chemotherapy, and erythropoietin might be protective. A previously reported study compared quality-of-life in women undergoing chemotherapy for breast cancer who were randomized to receive epoetin-alfa or standard care. Here, we report a non-randomized sub-study in which cognitive function of participants was evaluated at 12–30 months after chemotherapy.

Methods: The primary endpoint was the proportion of women with moderate–severe cognitive impairment, as measured by the High Sensitivity Cognitive Screen (HSCS). Subjects also completed the Revised Hopkins Verbal Learning Test (HVLT-R), the Functional Assessment of Cancer Therapy—Fatigue (FACT-F) and FACT-G self-report questionnaires for fatigue and quality-of-life, and the Hospital Anxiety and Depression Scale.

Results: Of 278 patients receiving adjuvant treatment in the primary study, 87 participated in the sub-study: 45 had received epoetin-alfa and 42 standard care. Groups were well matched for age and type of chemotherapy. Eight patients (9%) had moderate–severe cognitive dysfunction by the HSCS: six of them in the epoietin-alfa group (not significant). There were no significant differences in the HVLT-R, or in fatigue, but patients who had received epoetin-alfa reported better quality-of-life.

Conclusion: This study failed to demonstrate a protective effect of epoetin-alfa against the development of delayed cognitive dysfunction after chemotherapy. Copyright © 2008 John Wiley & Sons, Ltd.