1.
Recombinant human erythropoietins and cancer patients: updated meta-analysis of 57 studies including 9353 patients
Bohlius J, Wilson J, Seidenfeld J, Piper M, Schwarzer G, Sandercock J, Trelle S, Weingart O, Bayliss S, Djulbegovic B, et al
Journal of the National Cancer Institute. 2006;98((10):):708-14.
Abstract
This is an updated systematic review of 57 trials and 9353 cancer patients from articles, abstracts, and reports published between January 1, 1985, and April 30, 2005, on the effects of epoetin alfa and beta (i.e., epoetin) and darbepoetin alfa (i.e., darbepoetin). We included randomized controlled trials comparing epoetin or darbepoetin plus red blood cell transfusion with red blood cell transfusion alone for prophylaxis or treatment of anemia in cancer patients with or without concurrent antineoplastic therapy. The Cochrane Library, MEDLINE, EMBASE, and conference proceedings were searched. Effect estimates and 95% confidence intervals (CIs) were calculated with fixed-effects models. Treatment with epoetin or darbepoetin statistically significantly reduced the risk for red blood cell transfusions (relative risk (RR) = 0.64, 95% CI = 0.60 to 0.68; 42 trials and 6510 patients) and improved hematologic response (RR = 3.43, 95% CI = 3.07 to 3.84; 22 trials and 4307 patients). Treatment with epoetin or darbepoetin increased the risk of thrombo-embolic events (RR = 1.67, 95% CI = 1.35 to 2.06; 35 trials and 6769 patients) . Uncertainties remain as to whether and how epoetin or darbepoetin affects overall survival (hazard ratio = 1.08, 95% CI = 0.99 to 1.18; 42 trials and 8167 patients). Caution is advised when using epoetin or darbepoetin in combination with thrombogenic chemotherapeutic agents or for cancer patients who are at high risk for thrombo-embolic events.
2.
Effectiveness of erythropoietin in the treatment of patients with malignancies: methods and preliminary results of a Cochrane review
Bohlius JF, Langensiepen S, Engert A, Schwarzer G, Bennett CL
Best Practice & Research. Clinical Haematology. 2005;18((3):):449-54.
Abstract
Cancer and cancer therapy-associated anemia may have an impact on tumor response and overall survival. Additionally, anemia represents an important economic factor. Therefore, therapeutic alternatives such as erythropoietin (EPO) and red blood cell transfusions have to be evaluated systematically. The effectiveness of recombinant human EPO to prevent or alleviate anemia in patients with malignant disease was determined. Randomized controlled trials comparing prophylaxis or treatment of anemia with EPO plus red blood cell transfusion (RBCT) or RBCT only in patients with malignant disease undergoing antineoplastic therapy were included. The endpoints needed for RBCT were hematological response (hemoglobin increase of 2g/dL or hematocrit increase of 6%), tumor response, and overall survival. Medical databases (Cochrane Library, MEDLINE, EMBASE) and conference proceedings were searched (1985-2001). Full-text and abstract publications were included as well as unpublished data. Data extraction and quality assessment were done in duplicate. All authors were contacted to obtain missing data. Out of 33 eligible studies, 27 trials with 3,287 randomized patients were included.
3.
Recombinant human erythropoietin and overall survival in cancer patients: results of a comprehensive meta-analysis
Bohlius J, Langensiepen S, Schwarzer G, Seidenfeld J, Piper M, Bennett C, Engert A
Journal of the National Cancer Institute. 2005;97((7):):489-98.
4.
Does erythropoietin improve overall survival in the treatment of patients with malignant diseases? Results of a comprehensive meta-analysis
Bohlius JF, Langensiepen S, Schwarzer G, Bennet CL, Engert A
Blood. 2003;102((11, Pt 1):):203a.. Abstract No. 709.
5.
Epoietin in the treatment of malignant disease: a comprehensive meta-analysis
Bohlius JF, Langensiepen S, Schwarzer G, Engert A
Blood. 2002;100((11):): Abstract No. 3430.