Influence of Hemoglobin Response to Epoetin Alfa on Quality-of-Life in Anemic Children with Cancer Receiving Myelosuppressive Chemotherapy.

In a double-blind, placebo (PBO)-controlled study of children age 5–18 years (y) with cancer and anemia who received myelosuppressive chemotherapy (CT), the use of epoetin alfa (EPO) increased hemoglobin (Hb) levels (Hb increase ≥1 g/dL from baseline after 4 weeks [wks], independent of RBC transfusion in the previous 28 days; 65.0% for EPO vs 50.0% for PBO; P =.034) and reduced transfusion requirements (transfusion after wk 4 = 51.4% for EPO vs 69.4% for PBO; P =.008). However, no difference in the primary end point, self-reported quality of life (QOL) using the Pediatric Quality of Life Inventory (PedsQL-I™), was observed overall between the 2 treatment arms ( ProcASCO 23:abstract 8527, 2004). In adults, increases in Hb during EPO therapy are associated with improved QOL (Cancer95:888, 2002). Given these findings, this post-hoc analysis of the pediatric study was undertaken to determine if a difference in QOL outcomes is observed when the Hb response of children is considered. The study included patients (pts) who were receiving myelosuppressive CT for malignant solid tumors (ST), Hodgkin’s disease (HD), acute lymphocytic leukemia (ALL), or non-Hodgkin’s lymphoma (NHL) and who were anemic (Hb 12 y, Hb 12 y, and Hb Hb Response and PedsQL-I Score