DYNAMIC CHANGES IN SERUM ERYTHROPOIETIN LEVELS IN SOLID TUMOR PATIENTS UNDERGOING 41.8-DEGREES-C WHOLE-BODY HYPERTHERMIA AND OR CHEMOTHERAPY/

Whole Body Hyperthermia (WBH) has been shown to have physiological eff ects on myeloid and megakaryocytic haematopoietic tissue via both cyto kine induction. as well as hormonal changes. In order to extend this k nowledge base to the erythroid cells, endogenous erythropoietin (EPO) levels were studied in 17 cancer patients receiving 41.8 degrees C WBH and/or chemotherapy, as well as in 53 anaemic and non-anaemic control patients. Pre-treatment EPO levels showed a 'blunted' EPO response in cancer patients compared to the control patients. Posttreatment data demonstrated a significant chemotherapy induced increase in EPO levels with a peak at 36 to 48 hours (independent of changes in haemoglobin) and 10 to 13 days post chemotherapy (simultaneously with a drop in ha emoglobin levels). The early change in EPO levels was not influenced b y the addition of 41.8 degrees C (x 60 min) WBH to the same chemothera py regimen, i.e., ifosfamide, carboplatin, and etoposide. Taken collec tively, our data show that endogenous EPO levels in cancer patients ca n be effected by chemotherapy (independent of changes in haemoglobin). This EPO response to chemotherapy is not impacted on by 41.8 degrees C WBH. A relevant secondary conclusion can also be derived from this i nvestigation, i.e., caution should be exercised as to the use of EPO l evels during chemotherapy as predictors of exogenous EPO efficacy.