Plasma erythropoietin concentrations in patients receiving intensive platinum or nonplatinum chemotherapy

Aims Platinum chemotherapy has been shown to have potent antineoplastic act ivity against various rumours, especially testicular, bladder, ovarian, hea d and neck cancers. This activity is accompanied by side-effects of nephrot oxicity and cumulative myelosuppression, the latter frequently presenting a s severe anaemia. Cisplatin and carboplatin nephrotoxicity might lower eryt hropoietin (Epo) secretion and, by this mechanism, contribute to the anaemi a that follows therapy with this chemotherapeutic agent. The aim of the pre sent work is to study the plasma immunocrythropoietin and haemoglobin level s of cancer patients treated with platinum or 5-fluorouracil-based chemothe rapy. Methods Plasma was obtained from 25 patients who were about to receive chem otherapy for advanced malignancy: 15 treated with cisplatin or carboplatin and 10 with nonplatinum drugs. Blood was collected on the first day (before drug administration) and around day 15 of every chemotherapy course. Compl ete blood count, creatinine and immunoreactive Epo levels were also measure d in 22 healthy volunteers. Results An increase in Epo levels occurred following every course of 5-FU o r platinum based chemotherapy in patients with steady concentrations of cre atinine and decreased levels of haemoglobin (Hb). In particular, we observe d an increase after about 15 days of the chemotherapy treatment and the Epo levels declined toward normal just before the following course. This pheno menon was evident in every course. Conclusions Our results suggest that chemotherapy administration, using the current standards of hydration and forced diuresis, slightly lowered Hb le vels but did not depress Epo production, both in 5-FU and in platinum treat ed subjects.