ANEMIA ASSOCIATED WITH ADVANCED PROSTATIC ADENOCARCINOMA - EFFECTS OFRECOMBINANT-HUMAN-ERYTHROPOIETIN

BACKGROUND AND METHODS. Nine patients with hormone-refractory metastat ic prostatic adenocarcinoma and anemia were treated with recombinant h uman erythropoietin (rHuEpo) at a median dose of 150 U/kg BW 3 times a week subcutaneously. Baseline hemoglobin (Hb) ranged from 70 to 116 g /L, and the study duration was 12 weeks (median patient participation period was 8 weeks). RESULTS. Four patients demonstrated a median Hb i ncrease of 20 g/L and were considered responders. Three patients showe d a median increase of 17 g/L but required blood transfusion once, and were therefore considered as partial responders. Baseline erythropoie tic status showed a significant correlation between serum Epo and Hb. Inadequate Epo production, evaluated by the observed/predicted log Epo ratio, was found in two patients. Defective bone marrow activity, dem onstrated by low transferrin receptor (TfR), and hypoferremia in spite of abundant iron stores were also shown. Hemorheological investigatio ns showed elevated plasma viscosity. CONCLUSIONS. Our results indicate that suppression of erythropoiesis can be mainly explained by the dep ressed marrow activity. The altered hemorheology might contribute to t he anemia. This anemia could possibly be corrected with rHuEpo. (C) 19 97 Wiley-Liss, Inc.