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Corrected area under serum hemoglobin curve (Hb c-AUC) as a predictor of maximal hemoglobin response after erythropoietin (rHuEpo) treatment in chemotherapy induced anemia patients

Domenii publicaţii > Ştiinţe medicale + Tipuri publicaţii > Articol în revistã ştiinţificã

Autori: E. Banu, M. Levee, F. Scotte, A. Banu, S. Oudard, J. Ayllon, C. Le Maignan, B. Bonan, A. L. Le Louet, J. M. Andrieu

Editorial: Poster presentation. Abstract 9586. J Clin Oncol (supplement) 2004;22(14S):852., 2004.


Background: The concentration of serum hemoglobin (Hb) during rHuEpo treatment can be used to predict Hb response probability among patients (pts) treated by chemotherapy (CT). We were able to determine whether Hb dynamics over time correlate with rHuEpo efficacy defining a new predictive factor: Hb c-AUC. Methods: Our retrospective analysis validated the Hb c-AUC concept, defined as total Area Under serum Hb Curve (Hb AUC) per unit of time. Pts had regular Hb evaluation during rHuEpo treatment until blood cell transfusion, if applicable. The trapezoidal and Simpson’s rules were used to calculate the Hb AUC. Response was defined as an Hb increase of at least 1 g/dL over the treatment. Based on their Hb c-AUC values, pts were analyzed according to maximal Hb response. Cox regression and log-rank tests were used after adjustment according to the Hb baseline level. Results: A total of 91 pts were analyzed: 46 men and 45 women, with a median age 61 years; 81 pts with solid tumors and 10 pts with hematological malignancies were treated with CT. Twenty-seven pts presented bone metastases. Median rHuEpo treatment duration and Hb c-AUC value were 76 days (8–422 days) and 10,3 g/dL (6.7–13.8 g/dL), respectively. Hb response was observed in 67% of pts. There was a significant difference in Hb response in favor of the high (> 10 g/dL) vs. low ( 10 g/dL) Hb c-AUC level group (73% vs. 41%, p=0.002), respectively. Predictive variables for maximal Hb response in univariate analysis were lymphocyte baseline level (p=0.04) and Hb c-AUC (p=0.0001). Only Hb c-AUC variable remained significant in multivariate analysis. Transfusional requirements were reduced by 30% in favor of high Hb c-AUC group (20% vs. 50%). Conclusions: Since only a proportion of cancer anemic pts benefit from rHuEpo, a reliable means of predicting potential responders would be useful. This analysis suggests that response to rHuEpo can be earlier predicted by Hb dynamics over time: Hb c-AUC.

Cuvinte cheie: aria sub curba hemoglobinei, raspuns eritropoietic // Hemoglobin area under the curve, erythropoietic response