Abstract
6703 Background: Anemia is common in ALL, LL, and BL on chemotherapy (chemo) and is associated with poor cancer control. Studies have shown that even mild correction of anemia has been associated with a significant improvement in quality of life (QOL). The current treatment for anemia in ALL, LL, and BL is PRBC tx. However, tx are time consuming and carry risk of infection and tx reaction. There are at least 2 studies that suggest EPO use may impair disease control. Objectives: To evaluate if EPO 1) decreases number of tx, 2) improves QOL, and 3) adversely influences CR rate. Methods: Pts with newly diagnosed ALL, LL, or BL, receiving hyper-CVAD were randomized to EPO vs. SOC within 14 days of starting chemo. EPO dose was 40,000 units SQ weekly and escalated to 60,000 units after 4 weeks if indicated. Both arms received blood tx as per guidelines. Pts filled out 2 QOL questionnaires (Anderson Symptom Assessment Score (ASAS) and FACT-Anemia) within one week of each chemo course. Results: From September 2003 to November 2004, 30 pts were enrolled. The 2 groups were comparable in baseline characteristics (sex, diagnosis, baseline hemoglobin, number of courses, and weeks on study), but EPO treated pts had a tendency to be younger than SOC pts (34 vs 48, respectively (p=0.028)). The median number of tx after the first 4 weeks on study, was 13 in SOC and 7.5 for EPO arm (p=0.14). All patients achieved CR. ASAS scores for fatigue improved by a mean score of +3.75 in EPO arm vs +0.25 for SOC when baseline and course 3 scores were compared (p=0.049). FACT-Anemia scores improved from baseline in both groups when compared to course 3. This improvement was more evident in the EPO group for patients who had a baseline hemoglobin of 9 or greater (EPO +27 SOC +18 p=0.7128)). Conclusions: 1) In pts with ALL, LL, and BL on hyper-CVAD, EPO decreased the number of tx. 2) Pts treated with EPO report significant improvements in fatigue symptoms. 3) Use of EPO appears to have no impact on CR rate. No significant financial relationships to disclose.
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