Quality of life and brain function following high-dose recombinant human erythropoietin in low-risk myelodysplastic syndromes: a preliminary report.

Abstract

OBJECTIVE:

In this prospective study we evaluate the effects of high-dose recombinant human erythropoietin (rHuEPO) on quality of life (QOL) and brain function in patients with low-risk myelodysplastic syndromes (MDS) (<10% marrow blasts). Preliminary data are reported.

METHODS:

Eleven consecutive patients were given rHuEPO (40,000 IU two times a week) for 12 wk. Responsive patients continued with 40,000 IU/wk for further 12 wk. Changes in QOL were assessed by the Functional Assessment of Cancer Therapy-Anemia (FACT-An) self-report. Neurophysiological evaluation at the start of the therapy (t0) included duplex scanning of neck vessels, transcranial Doppler sonography (TCD), a complex neuropsychological evaluation, and quantitative electroencephalography (qEEG). Eight patients completed the neurophysiological evaluation after 24 wk (t1).

RESULTS:

Six patients (55%) achieved an erythroid response after 12 wk, which was maintained after 24 wk of treatment. FACT-An score showed a relevant improvement between t0 and t1 in these patients. At baseline, TCD showed a mean cerebral blood flow (CBF) velocity in the upper normal range. Abnormalities in brain function were observed in five patients. In the eight patients who were re-evaluated at t1, improvement was observed in three responding patients, two of them with abnormal values at t0. A strict correlation between QOL and neurophysiological improvements was not observed.

CONCLUSIONS:

A high-dose induction phase with rHuEPO followed by maintenance therapy may be an effective therapeutic schedule for low-risk MDS patients. The erythroid response was associated with positive changes in the QOL. Neurophysiological improvements occurred only in a part (50%) of responding patients, mainly those who showed altered results at baseline.

• Authors: Marino Clavio, Flavio Nobili, Enrico Balleari, Nicola Girtler, Filippo Ballerini, Paolo Vitali, Paola Rosati, Claudia Venturino, Riccardo Varaldo, Marco Gobbi, Riccardo Ghio, Guido Rodriguez
• Journal: European journal of haematology (Eur J Haematol) Vol. 72 Issue 2 Pg. 113-20 (Feb 2004) ISSN: 0902-4441 [Print] England
• PMID: 14962248 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Recombinant Proteins
• Erythropoietin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Brain (physiopathology)
• Electroencephalography
• Erythropoietin (therapeutic use)
• Fatigue
• Humans
• Middle Aged
• Myelodysplastic Syndromes (drug therapy, psychology, rehabilitation)
• Neuropsychological Tests
• Patient Selection
• Quality of Life
• Recombinant Proteins
• Surveys and Questionnaires