CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) ±° rituximab [(±°R)CHOP] is the current standard of care for aggressive non-Hodgkin lymphoma (NHL). Anemia resulting from chemotherapy can be treated with erythropoiesis-stimulating agents (ESAs). As part of the observational IMPACT NHL study, data were collected on ESA use and anemia-related outcomes in 1829 adults receiving (±°R)CHOP-14 or (±°R)CHOP-21. Overall, 33% of patients were anemic during chemotherapy. Older age, lower baseline hemoglobin (Hb), worse performance status, more advanced disease stage, and use of CHOP-14 were significant predictors of transfusion and anemia in logistic regression models. ESAs were received by 404 patients, usually in response to low or declining Hb levels. Most patients (65%) had Hb 9-11 g/dL at ESA initiation, and 89% (Kaplan-Meier percentage) achieved Hb 10-12 g/dL. In conclusion, two-thirds of anemic patients with NHL receiving (±°R)CHOP initiated ESA treatment at Hb 9-11 g/dL, and most achieved target Hb levels (10-12 g/dL).

CHOP chemotherapy, anemia, erythropoiesis-stimulating agents, non-Hodgkin lymphoma, observational study,
Leukemia and Lymphoma
Erasmus MC: University Medical Center Rotterdam

Haioun, C, Salar, A, Pettengell, R, Johnsen, H.E, Duehrsen, U, Gaia Rossi, F, … Lugtenburg, P.J. (2011). Anemia and erythropoiesis-stimulating agent administration in patients with non-Hodgkin lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisolone ± rituximab chemotherapy: Results from an observational study. Leukemia and Lymphoma, 52(5), 796–803. doi:10.3109/10428194.2011.557166