Erythropoietic growth factors for children with cancer: a systematic review of the literature

ABSTRACT

Objective: To review evidence on the use of erythropoietic stimulating agents (erythropoietin or darbepoetin) in children with cancer.

Methods: A systematic review of the published literature was performed using MEDLINE (1966–July 2007) and references from a Cochrane systematic review (focusing mainly on adults) published in 2006.

Results: The review identified 12 studies, comprising five randomized trials, six case control studies and one open-label, dose-escalation study. All the studies that used adequate doses of recombinant human erythro­poietin (rhEPO) (usually 150 IU/kg three times per week) demonstrated benefits for rhEPO except for one study in which rhEPO was added to G-CSF in children with high-risk neuroblastoma. Despite the heterogeneity of the populations studied, in terms of age, tumour type and chemotherapy regimen, rhEPO use was associated with consistent benefits in terms of reduced transfusion requirements and improved haematological parameters. Only one case of darbepoietin use was reported.

Conclusions: While more studies are required, it appears that rhEPO is safe in this vulnerable patient group and can benefit children with cancer by preventing or ameliorating anaemia.

Key words: :

• Anaemia
• Erythropoiesis
• Erythropoietin
• Oncology
• Paediatrics