Treatment of the anemia of multiple myeloma: The role of recombinant human erythropoietin

Patients with relatively higher endogenous EPO levels (>100 U/L) in the Arkansas study showed late responses or failed to respond, analogous to earlier observations by Ludwig et al, as well as by Fischl et al, and colleagues, who studied r-HuEPO administration in acquired immunodeficiency syndrome patients receiving r-HuEPO for anemia associated with zidovudine therapy. Thus, r-HuEPO substitution therapy is more likely to benefit patients whose anemia is associated with inappropriately low EPO serum levels. Granulopoiesis and thrombopoiesis were unaffected, and multiple myeloma cell stimulation has not been observed. The relative lack of toxicity from subcutaneously administered r-HuEPO at a dose of 150 U/kg three times weekly makes this approach an effective adjunct in the management of patients with multiple myeloma, especially those unresponsive to chemotherapy and remaining symptomatic from their anemia.