Experience in the use of human recombinant erythropoietin (rHuEPO) in cancer patient with anemia

Anemia in cancer patients can be the result of a variety of factors, often in combination. The chemotherapy-related myelosuppression is logically the main cause, but other conditions sometimes prevail, such as iron or folate deficiency, hemolysis, bleeding, or, as mentioned before, the combination of the above. Known as anemia of cancer or chronic disease, it is heralded by the disturbance of iron utilization and, recently, found to be accompanied by low erythropoetin levels. It is with the latter condition in mind that we have undertaken a study to assess responsiveness of the anemia of cancer to erythropoetin, in this case the human recombinant erythropoetin (rHuEPO). Five cancer patients with varying types of cancers who have undergone chemotherapy were recruited, and received rHuEPO 150 iu/kg, thrice weekly subcutaneously for a period of 16 weeks. Hemoglobin levels and hematocrit were monitored and at 12 weeks was noted an increase in hemoglobin levels by more than 2 g/dl and hematocrit measurement by more than 6% in 4 cases (80%). One case had increases less than the aforementioned but was made transfusion-free. We conclude that rHuEPO has an impressive hemoglobin-increasing effect.