Chronic Anemia Due to Mitomycin C Is Drug Dose-Dependent, Normocytic, Progressive, Related to Erythropoietin Levels and Quantitatively Predictable: Implications for Radiochemotherapy

• Published in: Journal of chemotherapy (Florence) 2011-12, Vol.23 (6), p.362-366
• Main Authors: Cartel, G., Colombrino, E., Sanzari, M.C., Plebani, M., Micucci, M., Fiorica, F., Glraldi, T., Zustovich, F., Cartel, F.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; ANEMIA; Anemia - blood; Anemia - chemically induced; Anemias. Hemoglobinopathies; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Biological and medical sciences; CHEMORADIOTHERAPY; Chemoradiotherapy - methods; Chronic Disease; Disease Progression; Diseases of red blood cells; Dose-Response Relationship, Drug; Erythrocytes - drug effects; ERYTHROPOI- ETIN; Erythropoietin - analysis; Erythropoietin - blood; Female; Hematocrit - methods; Hematologic and hematopoietic diseases; Hemoglobins - analysis; Hemoglobins - metabolism; Humans; Male; Medical sciences; Middle Aged; Mitomycin - administration & dosage; Mitomycin - adverse effects; MITOMYCIN C; Neoplasms - blood; Neoplasms - drug therapy; Neoplasms - radiotherapy; Neoplasms - therapy; Pharmacology. Drug treatments; Prospective Studies
• ISSN: 1120-009X; 1973-9478
• DOI: 10.1179/joc.2011.23.6.362

C.Mitomycin C (Me) is used as therapy against solid tu- mors, also combined with other chemotherapeutic agents or radiotherapy. It may cause acute, subacute, or chronic anemia capable of modifying the results of chemo- and ra- diotherapy. Erythropoietin may be lowered by cancer itself or because of chemoradiotherapy. There are few studies investigating the relationship between erythropoietin and chronic anemia. We prospectively analyzed the chronic anemia and ery- thropoietin in 38 patients with solid cancer. Patients were 40 to 82 years of age. MC was randomly given every 3 weeks as a single drug at 10 or 20 mg/m 2*When myelo- toxicity occurred the next therapy cycle was delayed until recovery. RBC indices, hemolysis, erythropoietin, liver and kidney function were studied. MC cycles were 136 (3.6 ±1.4 per pt), 32 being delayed because of myelotoxicity. Hematocrit, hemoglobin and RBC were inversely related to the cumulative dose (r = 0.70 to 0.86; p 0.03 to 0.01) of MC. Other tests remained stable. Anemia occurred almost twofold earlier in the 20 mg/m 2 group (p=0.049). Basal erythropoietin, already lower than in age and sex watched 81 non cancerous subjects (p