Effectiveness of darbepoetin alfa in multiple myeloma patients receiving chemotherapy including novel agents

Sung-Eun Lee; Young-Woo Jeon; Jae-Ho Yoon; Byung-Sik Cho; Ki-Seong Eom; Yoo-Jin Kim; Hee-Je Kim; Seok Lee; Seok-Goo Cho; Dong-Wook Kim; Jong Wook Lee; Woo-Sung Min; Chang-Ki Min

doi:10.5045/br.2018.53.2.123

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Original Article

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Blood Res 2018; 53(2):

Published online June 25, 2018

https://doi.org/10.5045/br.2018.53.2.123

Effectiveness of darbepoetin alfa in multiple myeloma patients receiving chemotherapy including novel agents

Sung-Eun Lee¹, Young-Woo Jeon¹, Jae-Ho Yoon¹, Byung-Sik Cho^1,2, Ki-Seong Eom^1,2, Yoo-Jin Kim^1,2, Hee-Je Kim^1,2, Seok Lee^1,2, Seok-Goo Cho¹, Dong-Wook Kim^1,2, Jong Wook Lee¹, Woo-Sung Min¹, and Chang-Ki Min^1,2*

Author Info. +

¹Department of Hematology, Seoul St. Mary's Hospital, Seoul, Korea.

²Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Correspondence to : Chang-Ki Min, M.D., Ph.D. Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 06591, Korea. ckmin@catholic.ac.kr

Received: November 19, 2017; Revised: December 11, 2017; Accepted: December 30, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Abstract

Background

The aim of this study was to evaluate the effects of darbepoetin alfa (DA) on hemoglobin (Hb) concentration and the need for transfusions in multiple myeloma (MM) patients receiving chemotherapy with novel agents.

Methods

Of 251 patients with MM who received DA therapy for at least 4 weeks, 142 who did not receive RBC transfusion during 4 weeks after DA initiation and started DA therapy at baseline Hb <10.0 g/dL were analyzed.

Results

After 4 weeks of DA therapy, 80 (60.6%) of 132 patients with evaluable data had Hb that increased ≥1.0 g/dL from baseline, while 50 (37.9%) had Hb that increased ≥2.0 g/dL from baseline. Pretreatment Hb level did not correlate with the proportion of patients with increased Hb. The median duration of DA therapy was 9.0 weeks. At the end of DA therapy, of 135 patients with evaluable data, 86 (60.6%) had Hb that increased ≥1.0 g/dL from baseline, while 67 (47.2%) had Hb that increased ≥2.0 g/dL from baseline. Stage III disease according to the International Staging System and absence of myeloma bone disease at diagnosis were independent predictors of higher Hb response during early DA therapy.

Conclusion

We demonstrated the efficacy of DA therapy in a homogeneous group of MM patients receiving chemotherapy. DA therapy significantly increased Hb concentration, regardless of baseline Hb level.

Keywords Multiple myeloma, Anemia, Erythropoietin

Article

Original Article

Blood Res 2018; 53(2): 123-129

Published online June 25, 2018 https://doi.org/10.5045/br.2018.53.2.123

Effectiveness of darbepoetin alfa in multiple myeloma patients receiving chemotherapy including novel agents

¹Department of Hematology, Seoul St. Mary's Hospital, Seoul, Korea.

²Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Correspondence to:Chang-Ki Min, M.D., Ph.D. Department of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 06591, Korea. ckmin@catholic.ac.kr

Received: November 19, 2017; Revised: December 11, 2017; Accepted: December 30, 2017

Abstract

Background

Methods

Results

Conclusion

We demonstrated the efficacy of DA therapy in a homogeneous group of MM patients receiving chemotherapy. DA therapy significantly increased Hb concentration, regardless of baseline Hb level.

Keywords: Multiple myeloma, Anemia, Erythropoietin

Abstract

Fig 1.

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Figure 1.Cumulative incidences of Hb response (≥2.0 g/dL).

Blood Research 2018; 53: 123-129https://doi.org/10.5045/br.2018.53.2.123

Fig 2.

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Figure 2.Mean (SEM) change in hemoglobin during darbepoetin alfa therapy. (A) Mean (SEM) changes in hemoglobin from baseline to 4 weeks and (B) to the end of darbepoetin alfa therapy.

Blood Research 2018; 53: 123-129https://doi.org/10.5045/br.2018.53.2.123

Table 1 . Patient characteristics..

^a)Induction+ASCT was considered in one therapeutic line..

Abbreviations: ANC, absolute neutrophil count; ASCT, autologous stem cell transplantation; CR, complete response; ECOG, Eastern Cooperative Oncology Group; F, female; Hb, hemoglobin; M, male; MM, multiple myeloma; NA, not available; PD, progressive disease; SD, stable disease; VGPR, very good partial response; WBC, white blood cell..

Table 2 . Hemoglobin endpoints..

Abbreviations: Hb, hemoglobin; NDMM, newly-diagnosed multiple myeloma; RRMM, relapsed/refractory multiple myeloma; SEM, standard error of the mean..

Table 3 . Percentage of patients receiving red blood cell transfusions..

Abbreviations: Hb, hemoglobin; NDMM, newly-diagnosed multiple myeloma; RBC, red blood cell; RRMM, relapsed/refractory multiple myeloma; SEM, standard error of the mean..

Table 4 . Univariate and multivariate analyses of variables affecting hemoglobin response<sup>a)</sup>..

^a)Factors affecting increases in Hb ≥2.0 g/dL after 4 weeks of darbepoetin alfa therapy were analyzed using logistic regression..

Abbreviations: ANC, absolute neutrophil count; ASCT, autologous stem cell transplantation; CI, confidential interval; F, female; Hb, hemoglobin; IMiDs, immunomodulatory drugs; M, male; NDMM, newly-diagnosed multiple myeloma; PR, partial response; RR, relative risk; RRMM, relapsed/refractory multiple myeloma; WBC, white blood cell..