ABSTRACT We describe the effects of Darbepoietin-alfa (Darbe) administration in Multiple Myeloma (MM) after autologous he-mopoietic progenitor cell transplantation (AHPCT). 26 MM patients undergoing AHPCT entered this study. 34 hemo-globin (Hb)-matched patients who had not received recombinant human erythropoietin (Epo) or Darbe and were treated with the same protocol were retrospectively selected for comparative data. Darbe (150 micro g total dose/weekly) was initiating in four weeks after AHPCT, with the aim of achieving an Hb level of ≥11 g/dl. The time to response to Darbe therapy was longer in the patients with Hb < 10 g/dL (p = 0.05) and with endogenous Epo levels ≤ 50 mU/ml (p = 0.0098). Hb level on day 60 and 90 after AHPCT, was faster for Darbe recipients (12.5, range 9.4 - 15.4, vs 10.6, range 8.8 - 13.4 g/dL, p = 0.0001, and 13.5, range 12.3 - 14.3, vs 12, range 9.8 - 14 g/dL, respectively, p = 0.0001). The need for Red Blood Cells transfusion, included in the period of 30 - 90 days post- AHPCT was similar (p = ns). This study demonstrates the accelerating effect of Darbe on Hb increase in the setting evaluated and shows that this effect signify- cantly depends on the endogenous Epo level at the start of treatment. The strategy of giving Darbe around 1 month after high-dose melphalan (HDM) doesn’t reduce RBC transfusion requirement.
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