Continuing erythropoietin during peripheral blood stem cell collection in myeloma: can it reduce toxicity of autologous transplants?

摘要

Erythropoietin (EPO) regulates the growth and production of red blood cells (RBCs) and has pleomorphiceffects on apoptosis and the regulation of vascular integrity . Randomized, placebo-controlled trials have demonstrated the benefits of recombinant human EPO (rHuEPO) to increase Hb levels, reduce transfusion requirements, and improve quality of life in anemic cancer patients undergoing chemotherapy [1,4,5]. Interestingly, rHuEPO also may provide a survival benefit for patients with multiple myeloma (MM) through beneficial changes in immune function [1,6]. Furthermore, rHuEPO can increase the number of circulating vascular progenitors and may play a role in the repair of ischemic tissue injury, such as myocardial infarction and stroke . Anemia before allogeneic hematopoieticstem cell transplantation (HSCT) has been associated with increased transfusion requirements and increased treatment-related mortality (TRM) . More recently, we have found that anemia on the day of peripheral blood progenitor cell (PBPC) collection influences graft content of vascular progenitors and is associated with increased toxicity after autologous HSCT . Herein we provide new insight on the possible effect of concomitant rHuEPO therapy during the mobilization of PBPCs in patients with MM undergoing autologous HSCT.