Österborg A, Brandberg Y, Hedenus MImpact of epoetin-beta on survival of patients with lymphoproliferative malignancies: long-term follow up of a large randomized study. Br J Haematol 129: 206-209

Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
British Journal of Haematology (Impact Factor: 4.71). 05/2005; 129(2):206-9. DOI: 10.1111/j.1365-2141.2005.05440.x
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Recent studies have suggested that epoetin treatment of anaemia may influence the survival of patients with cancer. We conducted an analysis of long-term survival in patients with lymphoproliferative malignancies treated with epoetin-beta or placebo in a large-scale study. This was a randomized, double-blind trial in which patients with transfusion-dependent anaemia and lymphoproliferative malignancy received epoetin-beta 150 IU/kg or placebo three times weekly for 16 weeks. Long-term survival data were analysed by standard Kaplan-Meier methods and differences between groups were assessed using a log-rank test. The intention-to-treat population consisted of 343 patients (epoetin-beta, n = 170; placebo, n = 173). There were no major differences between the two treatment groups in demographic or clinical characteristics/prognostic factors. A total of 110 (65%) patients died in the epoetin-beta group (censored, n = 60) and 109 (63%) died in the placebo group (censored, n = 64) up to the end of long-term follow up. Kaplan-Meier curves for survival were similar in both groups. Median survival was 17 months with epoetin-beta and 18 months with placebo. A log-rank test indicated no significant difference in survival (P = 0.76). This long-term follow up indicated that epoetin-beta has no significant effect on survival compared to placebo in anaemic patients with lymphoproliferative malignancies.

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Available from: Michael Hedenus, Sep 21, 2014
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    • "Of the 10 studies that reported mortality data, five [7,10,17,26,27,29] also reported a disease progression outcome; a meta-analysis of these five studies was performed. In this analysis, the OR for disease progression was 1.02 (95% CI, 0.81–1.30, "
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    ABSTRACT: Abstract Erythropoiesis-stimulating agents (ESAs) are approved to treat anemia in patients with non-myeloid malignancies receiving myelosuppressive chemotherapy. ESAs reduce transfusion rates, but some clinical studies suggest that ESAs may reduce survival or increase disease progression. This study-level meta-analysis examined the effects of darbepoetin alfa, epoetin alfa or epoetin beta on mortality, disease progression and transfusion incidence in patients with lymphoproliferative malignancies, using randomized, controlled trials of patients receiving chemotherapy and ESAs or standard of care. The odds ratio (OR) for mortality was 1.04 (95% confidence interval [CI], 0.81-1.34, random-effects model, 10 studies); the risk difference was - 0.01 (95% CI, - 0.03-0.02). The OR for disease progression was 1.02 (95% CI 0.81-1.30, random-effects model, five studies). A lower proportion of ESA-treated patients than controls received transfusions (seven studies). In this meta-analysis, ESAs reduced transfusions with no clear effect on mortality or disease progression in patients with lymphoproliferative malignancies receiving chemotherapy.
    Leukemia & lymphoma 04/2012; 53(11):2151-8. DOI:10.3109/10428194.2012.684347 · 2.89 Impact Factor
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    • "A retrospective study of 257 MM patients indicated that ESA use was associated with improved survival (Baz et al, 2007), whereas another multivariate analysis of 323 patients suggested that ESA use had a detrimental effect on survival (Katodritou et al, 2008). A third, long-term follow-up study in patients with lymphoproliferative malignancies showed that epoetin-beta had no significant effect on OS compared with placebo (Osterborg et al, 2005). However, it should be noted that many of these studies were conducted before the change in recommendations regarding ESA use was made; current guidelines state that ESAs should only be initiated when haemoglobin is <100 g/l (Durie et al, 2003) and discontinued once haemoglobin reaches 120 g/l (Juneja et al, 2008). "
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    British Journal of Haematology 03/2011; 153(2):212-21. DOI:10.1111/j.1365-2141.2011.08569.x · 4.71 Impact Factor
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    • "In all , 4 of the 20 chemotherapy studies could not be included in the patient - level analysis as primary data were not available ( Oster - borg et al , 2005 ; Engert , 2007 ; Strauss et al , 2008 ; Aapro et al , 2008a ) . However , the published manuscripts for Aapro et al ( 2008a ) and Osterborg et al ( 2005 ) provided HRs for survival . Thus , sensitivity analyses were also carried using the published HRs for these two studies . "
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