Erythropoiesis after therapy with recombinant human erythropoietin: A dose-response study in anemic cancer surgery patients

Background and Objectives: Preoperative treatment with 600 U/kg of recombin ant human erythropoietin (r-HuEPO) effectively increases erythropoiesis in cancer patients. The aim of this study was to evaluate the erythropoietic r esponse after different doses of r-HuEPO in order to find the minimum effec tive dose, Materials and Methods: Twenty anemic sideropenic patients (hemog lobin less than or equal to 110 g/l; serum iron <600 mu g/l) with cancer of the gastrointestinal tract were randomly allocated to two groups: the firs t (n = 10) received 400 U/kg of r-Hu EPO divided in 4 doses (100 U/kg each, every 4 days); the second (n = 10) received 200 U/kg of r-HuEPO (50 U/kg e ach, every 4 days). Both groups were given intravenous iron gluconate (125 mg) every day for 15 days. Results: After treatment, the serum iron level s ignificantly rose in both groups. The production of new red blood cells was 176.3+/-90.8 mi in the 200 U/kg group and 268.4+/-79.4 mi in the 400 U/kg group (p = 0.036). The in crease of hemoglobin was significantly higher in the 400 U/kg group (22.3+/-2.0 g/l) than in the 200 U/kg group (14.1+/-2.7 g/l) (p = 0.017), Conclusion:The r-HuEPO dose of 400 U/kg appears significa ntly more effective than the 200 U/kg to stimulate erythropoiesis in anemic sideropenic cancer patients.