Pathogenesis and treatment of anaemia in malignant neoplasms (Review of literature)

Pediatric Hematology/Oncology and Immunopathology

Volumn 2, Issue 2, 2003, Pages 52-62

  Rumyantseva, U V ^a   Smetanina, N S ^a   Rumyantsev, A G ^a  

^a N N BLOKHIN NATIONAL MEDICAL RESEARCH CENTER OF ONCOLOGY   (Russian Federation)

Author keywords

Anaemia in malignant neoplasms; Erythropoietin; Myelodysplasic syndrome; Solid tumors; Therapy

Indexed keywords

EID: 17144417049     PISSN: 17261708     EISSN: 24149314     Source Type: Journal    
DOI: None     Document Type: Article

References (118)

1. Ludwig H., Fritz E. Anemia in cancer patients. Semin Oncol 1998; 25: 2–6.
2. Skillings J., Sridhar F.M., Wong C., Paddock L. The frequency of red cell transfusion for anemia in patients receiving chemotherapy. A retrospective cohort study. Am J Clin Oncol 1993; 16: 22–5.
3. Barrett-Lee P.J., Bailey N.P., O’Brien M.E.R., Wagner E. Large-scale UK audit of blood transfusion requirements and anemia in patients receiving cytotoxic chemotherapy. Br J Cancer 2000; 82: 93–7.
4. Groopman J.E., Itri L.M. Chemotherapy-induced anemia in adults: incidence and treatment. J Natl Cancer Inst 1999; 91: 1616–34.
5. Ray-Coquard I., Le Cesne A., Rubio M.T., et al. Risk model for severe anemia requiring red blood cell transfusion after cytotoxic conventional chemotherapy regimens. J Clin Oncol 1999; 17: 2840–46.
6. Smyth J.F., et al., eds. rhErythropoietin in cancer supportive treatment. 1996, New York.
7. Honda K., Ishiko O., Tatsuta J. Anemia-inducing substance from plasma of patients with advanced malignant neoplasms. Cancer Res 1995; 55: 3628–31.
8. Rumiantsev A.G., Morshchakova E.F., Pavlov A.D. Erythropoietin: biological properties, mechanisms of action and production, clinical application. Budapest; 2002.
9. Alvarez-Hernandez X., Liceaga J., McKay J.C., Brock J.H. Induction of hypofer-remia and modulation of macrophage iron metabolism by tumor necrosis factor. Lab Invest 1989; 61: 319–25.
10. Roodman G.D., Bird A., Hutzler D., Montgomery W. Tumor necrosis factor-alpha and hematopoietic progenitors: effect of tumor necrosis factor on the growth of erythroid progenitors CFU-E and BFU-E and the hematopoietic cell lines K562, HL60 and HEL cells. Exp Hematol 1987; 15: 928–35.
11. Furmanski P., Johnson C.S. Macrophage control of normal and leukemic ery-thropoiesis: identification of the macrophage-derived erythroid suppressing activity as interleukin-1 and the mediator of its in vivo action as tumor necrosis factor. Blood 1990; 75: 3128–34.
12. Ulich R., Shin S.S., del Castillo J. Hematological effects of TNF. Res Immunol 1993; 144: 346–54.
13. Johnson C.S., Cook C.A., Furmanski P. In vivo suppression of erythropoiesis by tumor necrosis factor-alpha: reversal with exogenous erythropoietin (EPO). Exp Hematol 1990; 18: 109–13.
14. Broxmeyer H.E., William D.E., Lu L., et al. The suppressive influence of human tumor necrosis factor on bone marrow hematopoietic progenitor cells from normal donors and patients with leukemia: synergism of tumor necrosis factor and interferon-γ. J Immunol 1986; 136: 4487–95.
15. Means T.R., Krantz S.B. Inhibition of human erythroid colony-forming units by gamma interferon can be corrected by recombinant human erythropoietin. Blood 1991; 78: 2564–7.
16. Faquin W.C., Schneider T.J., Goldberg M.A. Effect of inflammatory cytokines on hypoxia-induced erythropoietin production. Ibid 1992; 79: 1987–94.
17. Vannucchi A.M., Gross A., Rafanelli D., et al. Inhibition of erythropoietin production in vitro by human interferon gamma. Br J Haematol 1994; 87: 18–31.
18. Kettelhack C., Schuter D., Matthias D., Schlag P.M. Serum erythropoietin levels in patients with solid tumors. Eur J Cancer 1994; 30A: 1289–91.
19. Miller C.B., Jones R.J., Piantadosi S., et al. Decreased erythropoietin response in patients with the anemia of cancer. n Engl J Med 1990; 325: 1689–92.
20. Jelkmann W., Wolff M., Fandrey J. Inhibition of erythropoietin production by cytokines and chemotherapy may contribute to the anemia in malignant diseases. In: Waupel P., ed. Oxigen transport to tissue. New York; 1994.
21. Abels R. Erythropoietin for anemia in cancer patients. Eur J Cancer 1993; 29А(suppl. 2): 2–8.
22. Henry D.H., Brooks B.J. Jr. Case D.C. Jr., et al. Recombinant human erythro-poietin therapy for anemic cancer patients receiving cisplatin chemotherapy. Cancer J Sci Am 1995; 1: 252.
23. Beguin Y., Loo M., Zik S., et al. Quantitative assessment of erythropoiesis in haemodialysis patients demonstrates gradual expansion of erythroblasts during constant treatment with recombinant human erythropoietin. Br J Haematol 1995; 89: 17–31.
24. Glaspy J., Bukowski R., Steinberg D., et al. Impact of therapy with epoetin alfa on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. Procrit Study Group. J Clin Oncol 1997; 15: 1218–34.
25. Demetri G.D., Kris M., Wade J., et al. Quality-of-life benefit in chemotherapy patients treated with epoetin alpha is independent of disease response or tumor type: results from a prospective community oncology study. Procrit Study Group. Ibid 1998; 16: 3412–25.
26. Cascinu S., Fedeli A., Del Ferro E., et al. Recombinant human erythropoietin treatment in cisplatin-associated anemia: A randomized, double-blind trial with placebo. Ibid 1994; 12: 1058–62.
27. Markman M., Reichman B., Hakes T., et al. The use of recombinant human ery-thropoietin to prevent carboplatin-induced anemia. Gynecol Oncol 1993; 49: 172–6.
28. Cazzola M., Ponchio L., Beguin Y., et al. Subcutaneous erythropoietin for the treatment of refractory anemia in hematological disorders. Results of a phase I/II clinical trial. Blood 1992; 79: 34–7.
29. Cazzola M., Messinger D., Battistel V., et al. Recombinant human erythropoietin in the anemia associated with multiple myeloma or non-Hodgkin’s lymphoma: dose finding and identification of predictors of response. Ibid 1995; 86: 4446–53.
30. Osterborg A., Boogaerts M.A., Cimina R., et al. Recombinant human erythro-poietin in transfusion-dependent anemic patients with multiple myeloma and non-Hodgkin’s lymphoma – a randomized multicenter study. Ibid 1996; 87: 3225–82.
31. Case D.C. Jr., Bukowski R.M., Carey R.W., et al. Recombinant human erythro-poietin therapy for anemic cancer patients on combination chemotherapy. J Natl Cancer Inst 1993; 85: 801–6.
32. Silvestris F., Romito A., Fanelli P., et al. Long-term therapy with recombinant human erythropoietin (rHu-EPO) in progressing multiple myeloma. Ann Hematol 1995; 70: 313–8.
33. Kurz С., Marth С., Windbichler G., et al. Erythropoietin treatment under poly-chemotherapy in patients with gynecologic malignancies: A prospective, ran-domized, double-blind placebo-controlled multicenter study. Gynecol Oncol 1997; 65: 461–6.
34. Oberhoff С., Neri В., Amadori D., et al. Recombinant human erythropoietin in the treatment of chemotherapy-induced anemia and prevention of transfusion requirement associated with solid tumors: A randomized, controlled study. Ann Oncol 1998; 9: 255–320.
35. Littlewood T.J., Bajetta E., Nortier J.W., et al. Effects of epoetin alpha on hema-tological parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: Results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 2001; 19: 2865–74.
36. Lavey R.S., Dempsey W.H. Erythropoietin increases hemoglobin in cancer patients during radiation therapy. Int J Rad Oncol Biol Phys 1993; 27: 1147–52.
37. Dusenbery K.E., McGuire W.A., Holt P.J., et al. Erythropoietin increases hemoglobin during radiation therapy for cervical cancer. Ibid 1994; 29: 1079–84.
38. Henke M., Guttenberger R. Barke A., et al. Erythropoietin for patients undergoing radiotherapy: A pilot study. Radiother Oncol 1999; 50: 185–90.
39. Wurnig С., Windhager R., Schwameis E., et al. Prevention of chemotherapy-induced anemia by the use of erythropoietin in patients with primary malignant bone tumors (a double-blind, randomized, phase III study). Transfusion 1996; 36: 155–9.
40. ten Bokkel Huinink W.W., de Swan C.A., van Toorn D.W., et al. Controlled multi-center study of the influence of subcutaneous recombinant human erythropoietin on anemia and transfusion dependency in patients with ovarian carcinoma treated with platinum-based chemotherapy. Med Oncol 1998; 15: 174–82.
41. Quirt I., Coutere F., Pichette R., et al. The role of recombinant human erythro-poietin (EPO) in reducing red blood cell transfusions and maintaining quality of life (QOL) in patients with lymphoma and solid tumors receiving cytotoxic chemotherapy: Results of a randomized, double-blind, placebo-controlled clinical trial. Blood 1996; 88: 347a.
42. Thatcher N., De Campos E.S., Bell D.R., et al. Epoetin alpha prevents anemia and reduces transfusion requirements in patients undergoing primarily platinum-based chemotherapy for small cell lung cancer. Br J Cancer 1999; 80: 396–402.
43. Cheung W.K., Goon B.L., Guilfoyle M.C., et al. Pharmacokinetics and pharmaco-dynamics of recombinant human erythropoietin after single and multiple subcutaneous doses to healthy subjects. Clin Pharmacol Ther 1998; 64: 412–31.
44. Cheung W., Minton N., Gunawardena K. Pharmacokinetics and pharmacody-namics of epoetin alpha once weekly and three times weekly. Eur J Clin Pharmacol 2000; 57: 411–8.
45. Gabrilove J.L., Cleeland C.S., Livingston R.B., et al. Clinical evaluation of once-weekly dosing of epoetin alpha in chemotherapy patients: Improvements in hemoglobin and quality of life are similar to three-times-weekly dosing. J Clin Oncol 2001; 19: 2875–82.
46. Ponchio L., Beguin Y., Farina G., et al. Evaluation of erythroid marrow response to recombinant human erythropoietin in patients with cancer anemia. Haematologica 1992; 77: 494–501.
47. Del Mastro L., Venturini M., Lionetto R., et al. Randomized phase III trial evalu-ating the role of erythropoietin in the prevention of chemotherapy-induced ane-mia. J Clin Oncol 1997; 15: 2715–21.
48. Wurnig C., Windhager R., Schwameis E., et al. Prevention of chemotherapy-induced anemia by the use of erythropoietin in patients with primary malignant bone tumors (a double-blind, randomized, phase III study). Transfusion 1996; 36: 155–9.
49. Welch R.S., James R.D., Wilkinson P.M. Recombinant human erythropoietin and platinum-based chemotherapy in advanced ovarian cancer. Cancer J Sci Am 1995; 1: 261.
50. Sweeney P.J., Nicolae D., Ignacio L., et al. Effect of subcutaneous recombinant human erythropoietin in cancer patients receiving radiotherapy: final report of a randomized, open-labelled, phase II trial. Br J Cancer 1998; 77: 1996–2002.
51. Platanias L.C., Miller C.B., Mick R., et al. Treatment of chemotherapy-induced anemia with recombinant human erythropoietin in cancer patients. J Clin Oncol 1991; 9: 2021–6.
52. Pawlicki M., Jassem J., Bosze P., et al. A multicenter study of recombinant human erythropoietin (epoetin alpha) in the management of anemia in cancer patients receiving chemotherapy. Anticancer Drugs 1997; 8: 949–57.
53. Glaspy J., Jadeja J.S., Justice G., et al. A dose-finding and safety study of novel erythropoiesis stimulating protein (NESP) for the treatment of anemia in patients receiving multicycle chemotherapy. Br J Cancer 2001; 84: 17–31.
54. Kotasek D., Berg R., Poulsen E., et al. Randomized, double-blind, placebo con-trolled, phase I/II dose finding study of Aranesp administered once every three weeks in solid tumor patients. Blood 2000; 96: 344a.
55. Pirker R., Vansteenkiste J., Gateley J., et al. A phase III double-blind, placebo-controlled, randomized study of novel erythropoiesis stimulating protein (NESP) in patients undergoing platinum treatment for lung cancer: NESP 980347 Study Group. Proc Am Soc Clin Oncol 2001; 20: 394a.
56. Hedenus M., Hansen S., Dewey C., et al. A randomized, blinding, placebo-con-trolled, phase II, dose-finding study of novel erythropoiesis stimulating protein (NESP) in patients with lymphoproliferative malignancies. Ibid: 393a.
57. Glaspy J.A., Jadeja J., Justice G., et al. Randomized, active controlled, phase 1/2, dose-escalation study of NESP administer weekly and every 2 weeks in patients with solid tumors. Ibid: 387a.
58. Kotasek D., Albertsson M., Mackey J., et al. Randomized, double blind, placebo-controlled, dose-finding study of darbepoetin alpha administered once every 3 (Q3W) or 4 (Q4W) weeks in patient; with solid tumors: Darbepoetin alpha 980341 Study Group. Ibid 2002; 21: 356a.
59. Rizzo J.D., Lichi A.E., Woolf S.H., et al. Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical oncology and the American Society of Hematology. J Clin Oncol 2002; 20: 4083–107.
60. Arlad С., Clifford D., Penfold G., et al. Erythropoietin response in anemic patients with multiple myeloma and other lymphoid malignancies infiltrating the bone marrow. Eur J Haematol 1992; 49: 59–62.
61. Singh A., Eckardt K.U., Zimmermann A., et al. Increased plasma viscosity as a reason for inappropriate erythropoietin formation. J Clin Invest 1993; 91: 251–6.
62. Cazzola M., Mercuriali F., Brugnaru C. Use of recombinant human erythropoietin outside the setting of uremia. Blood 1997; 89: 4318–22.
63. Ludwig H., Fritz E., Kotzmann H., et al. Erythropoietin treatment of anemia associated with multiple myeloma. N Engl J Med 1990; 325: 1693–9.
64. Barlogie В., Beck Т. Recombinant human erythropoietin and the anemia of multiple myeloma. Stem Cells 1993; 11: 88–94.
65. Kasper C., Terhaar A., Fossa A., et al. Recombinant human erythropoietin in the treatment of cancer-related anemia. Eur J Haematol 1997; 58: 251–6.
66. Molica S. Erythropoietin treatment of anemia associated with lymphoproliferative disorders. Eur J Cancer 1993; 34A: 1499–500.
67. Oster W., Herrmann F., Gamm H., et al. Erythropoietin for the treatment of anemia of malignancy associated with neoplastic bone marrow infiltration. J Clin Oncol 1990; 8: 956–62.
68. Henry D.H., Abels R.I. Recombinant human erythropoietin in the treatment of cancer and chemotherapy-induced anemia: Results of double blind and open-label follow-up studies. Semin Oncol 1994; 21: 21–8.
69. Pangalis G.A., Poziopoulos C., Angelopoulou M.K., et al. Effective treatment of disease-related anemia in B-chronic lymphocytic leukemia patients with recom-binant human erythropoietin. Br J Haematol 1995; 89: 622–34.
70. Rose E., Rai K., Revicki D. Clinical and health status assessments in anemic chronic lymphocytic leukemia (CLL) patients treated with epoetin alpha (EPO). Blood 1994; 84: 256.
71. Mittelman M., Zeidman A., Fradin Z., et al. Recombinant human erythropoietin in the treatment of multiple myeloma-associated anemia. Acta Haematol 1997; 98: 204–10.
72. Dammacco F., Silvestris F., Castoldi G.L., et al. The effectiveness and tolerabili-ty of epoetin alfa in patients with multiple myeloma refractory to chemotherapy. Int J Clin Lab Res 1998; 28: 122–34.
73. Bouranteas K.L. Recombinant human erythropoietin for the treatment of anemia in chronic myelogenous leukemia. Eur J Haematol 1997; 59: 323–5.
74. Siakantaris M.P., Angelopoulou M.K., Vassilakopoulos T.P., et al. Correction of disease-related anemia of B-chronic lymphoproliferative disorders by recombi-nant human erythropoietin: maintenance is necessary to sustain response. Leuk Lymphoma 2000; 40: 141–7.
75. Russo F., Guadagni S., Mattera G., et al. Combination of granulocyte-macrophage colony-stimulating factor (GM-CSF) and erythropoietin (EPO) for the treatment of advanced non-responsive chronic lymphocytic leukemia. Eur J Haematol 1999; 63: 325–31.
76. Garton J.P., Gertz M.A., Witzig ТЕ, et al. Epoetin alfa for the treatment of the anemia of multiple myeloma. Arch Intern Med 1995; 155: 2069–74.
77. Ludwig H., Rai K., Blade J, et al. Management of disease-related anemia in patients with multiple myeloma or chronic lymphocytic leukemia: epoetin treatment recommendations. The Hematology J, 2002; 3: 121–30.
78. Verhoef G.E.G., Boogaerts M.A. rhEPO in the treatment of the myelodysplastic syndromes. In: Smyth J.F., et al., eds. rhErythropoietin in cancer supportive treatment. New York: Marcel Dekker; 1996: 13–34.
79. Hellstrom-Lindberg E. Efficiency of erythropoietin in the myelodysplastic syndromes: a meta-analysis of 205 patients from 17 studies. Br J Haematol 1994; 89: 67–71.
80. Laporie J.P.N., Isnard F., Fenaux P. Recombinant human erythropoietin at high dose is effective for the treatment of the anemia of myelodysplastic syndromes. Contrib Nephrol 1991; 88: 221–2.
81. Casadevall N., Belunger С., Goy A., et al. High dose recombinant human ery-thropoietin administered intravenously for the treatment of anemia of myelodys-plastic syndromes. Acta Haematol 1992; 87: 22–5.
82. Goy A., Belariger C., Casadevall N., et al. High doses of recombinant erythro-poietin for the treatment of anemia of myelodysplastic syndromes. Br J Haematol 1993; 84: 312–7.
83. A randomized double-blind placebo-controlled study with subcutaneous recom-binant human erythropoietin in patients with low-risk myelodysplastic syn-dromes: Italian Cooperative Study Group for rHuEpo in Myelodysplastic Syndromes. Ibid 1998; 103: 1070–4.
84. Imamura M., Kobayashi M., Kobayashi S., et al. Failure of combination therapy with recombinant granulocyte colony-stimulating factor and erythropoietin in myelodysplastic syndromes. Ann Hematol 1993; 68: 163–6.
85. Negrin R.S., Stein R., Doherty K., et al. Maintenance treatment of the anemia of myelodysplastic syndromes with recombinant human granulocyte colony-stimu-lating factor and erythropoietin: evidence for in vivo synergy. Blood 1996; 87: 4076–81.
86. Nagler A., Biner C., Murkicban M.L., et al. Impact of marrow cytogenetics and morphology on in vitro hematopoiesis in the myelodysplastic syndromes: comparison between recombinant human granulocyte colony-stimulating factor (CSF) and granulocyte-monocyte CSF. Ibid 1990; 76: 1307–49.
87. Hellstrom-Lindberg E., Ahlgren T., Beguin Y., et al. Treatment of anemia in myelodysplastic syndromes with granulocyte colony-stimulating factor plus ery-thropoietin: results from randomized phase II study and long-term follow-up of 71 patients. Ibid 1998; 92: 68–75.
88. Remacha A.F., Arrizablaga B., Villegas A., et al. Erythropoietin plus granulocyte colony-stimulating factor in the treatment of myelodysplastic syndromes. Identification of a subgroup of responders. Haematologica 1999; 84: 1058–64.
89. Mantovani L., Lentini G., Hentschel B., et al. Treatment of anemia in myelodysplas-tic syndromes with prolonged administration of recombinant human granulocyte colony-stimulating factor and erythropoietin. Br J Haematol 2000; 109: 367–75.
90. Stasi R., Pagano A., Terzoli E., Amadori S. Recombinant human granulocyte-macrophage colony stimulating factor plus erythropoietin for the treatment of cytopenias in patients with myelodysplastic syndromes. Ibid 1999; 105: 141–8.
91. Economopoulos T., Mellou S., Papageorgiou E., et al. Treatment of anemia in low risk myelodysplastic syndromes with granulocyte-macrophage colony stimulating factor plus recombinant human erythropoietin. Leukemia 1999; 13: 1009–12.
92. Thompson J.A., Gilliland D.G., Prchal J.T., et al. Effect of recombinant human erythropoietin combined with granulocyte/macrophage colony-stimulating factor in the treatment of patients with myelodysplastic syndrome. Blood 2000; 95: 1175–9.
93. Bernell P., Stenke L., Wallvik J., et al. A sequential erythropoietin and GM-CSF schedule offers clinical benefits in the treatment of anemia in myelodysplastic syndromes. Leukemia Res 1996; 20: 693–9.
94. Rose E.H., Abels R.J., Nelson R.A., et al. The use of rHuEpo in the treatment of anemia related to myelodysplasia (MDS). Br J Haematol 1995; 98: 831–7.
95. Stein R.S., Abels R.J., Kraniz S.B. Pharmacological doses of recombinant human erythropoietin in the treatment of myelodysplastic syndromes. Blood 1991; 78: 1658–63.
96. Bowen D., Culligan D., Jacobs A. The treatment of anemia in the myelodysplas-tic syndromes with recombinant human erythropoietin. Br J Haematol 1991; 77: 419–31.
97. Beck M.N., Beck D. Recombinant erythropoietin in acute chemotherapy-induced anemia of children with cancer. Med. Pediatr Oncol 1995; 25: 17–21.
98. Mott M.G., Bargess M.F. Pediatric malignancy. Medicine 1995; 31: 460–3.
99. Corazza F., Beguin Y., Bergmann P., Sariban E. Anemia in children with cancer is associated with decreased erythropoietic activity and not with inadequate ery-thropoietin production. Blood 1998; 92: 1793–8.
100. Feusner J., Hastings C. Recombinant human erythropoietin in pediatric onco-logy: A review. Med Pediatr Oncol 2002; 39:463–8.
101. Leon P., Jimenez M., Barona P., Sierrasesumaga L. Recombinant human ery-thropoietin for the treatment of anemia in children with solid malignant tumors. Ibid 1998; 30: 110–6.
102. Csaki C., Ferencz T., Schuler D., Borsi J.D. Recombinant human erythro-poietin in the prevention of chemotherapy-induced anemia in children with malignant solid tumors. Eur J Cancer 1998; 34: 364–7.
103. Porter J.C., Leahey A., Polise K., et al. Recombinant human erythropoietin reduces the need for erythrocyte and platelet transfusions in pediatric patients with sarcoma: a randomized, double-blind, placebo-controlled trial. J Pediatr 1996; 134: 656–60.
104. Varan A., Buyukpamukcu M., Kutluk T., Akyuz C. Recombinant human ery-thropoietin treatment for chemotherapy-related anemia in children. Pediatrics 1999; 103: E16.
105. Benneis G., Beriulone S., Bray G., et al. Erythropoietin reduces volume of red cell transfusions required in some subsets of children with acute lympho-cytic leukemia. Blood 1995; 86: 853a.
106. Borsi J.D., Csaki C., Ferencz T. The use of rhEPO in the prevention and treatment of cytostatics-induced anemia in children. In: Smyth J.F., et al., eds. rhErythropoietin in cancer supportive treatment. New York; 1996: 134–9.
107. Dornbusch P. Clinical efficacy of rHuEPO in the treatment of cancer-related anemia in pediatric patients. Erythropoiesis 1996; 7: 40–5.
108. Dornbusrh P., Urban C., Thalmann E. Recombinant human erythropoietin (rHuEPO) in the treatment of chronic anemia in pediatric cancer and chemotherapy. Blood 1995; 86: 636a.
109. Bolonaki I., Stiakaki E., Lydaki E., et al. Treatment with recombinant human erythropoietin in children with malignancies. Pediatr Hematol Oncol 1996; 13: 111–21.
110. Beguin G., Loo M.R., Zik S., et al. Early prediction of response to recombinant human erythropoietin in patients with anemia of renal failure by serum trans-ferrin receptor and fibrinogen. Blood 1993; 82: 2010–16.
111. Platunius L.C., Miller C.B., Mick R., et al. Treatment of chemotherapy-induced anemia with recombinant human erythropoietin in cancer patients. J Clin Oncol 1991; 9: 2021–32.
112. Beguin Y., Clemons G.K., Pootrakul P., Fillet G. Quantitative assessment of erythropoiesis and functional classification of anemia based on measure-ments of serum transferrin receptor and erythropoietin. Blood 1993; 81: 1067–76.
113. Ludwig H., Fritz E., Laitgeb C., et al. Prediction of response to erythropoietin treatment in chronic anemia of cancer. Ibid 1994; 84: 1056–63.
114. Cazzola M., Ponchio L., Pedrotti C., et al. Prediction of response to recombi-nant human erythropoietin (rHuEpo) in anemic of malignancy. Haematologica 1996; 81: 434–41.
115. Henry D., Abels R., Larholt K. Prediction of response to recombinant human erythropoietin (rHuEpo/epoetin alpha) therapy in cancer patients. Ibid 1995; 85: 1676–78.
116. Mittelman M., Lessin L.S. Clinical application of recombinant erythropoietin in myelodysplasia. Hematol Oncol N Am 1994; 8: 993–1010.
117. Ohio R., Balteari E., Buileslrero A., et al. Subcutaneous recombinant human erythropoietin for the treatment of anemia in myelodysplastic syndromes. Acta Haematol 1993; 90: 58–64.
118. Stone P.M., Bernstein S.H., Demetri G., et al. Therapy with recombinant human erythropoietin in patients with myelodysplastic syndromes. Leukemia Res 1994; 18: 769–76.