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Quality of life and brain function following high‐dose recombinant human erythropoietin in low‐risk myelodysplastic syndromes: a preliminary report
Author(s) -
Clavio Marino,
Nobili Flavio,
Balleari Enrico,
Girtler Nicola,
Ballerini Filippo,
Vitali Paolo,
Rosati Paola,
Venturino Claudia,
Varaldo Riccardo,
Gobbi Marco,
Ghio Riccardo,
Rodriguez Guido
Publication year - 2004
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1046/j.0902-4441.2003.00183.x
Subject(s) - medicine , erythropoietin , quality of life (healthcare) , myelodysplastic syndromes , prospective cohort study , oncology , anemia , bone marrow , nursing
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.