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All Journal International Journal of Integrated Health Sciences Indonesian Journal of Cancer
Benny Isakh
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Strategy for the Use of Erythropoetin Alpha to Maintain Hemoglobin Level in Breast Cancer Patient Treated with Anthracycline-base of Adjuvant Chemotherapy Dimyati Achmad; Yusuf Hariady Hariady; Benny Isakh; Maman Abdurrahman; Ahmad Faried
International Journal of Integrated Health Sciences Vol 1, No 1 (2013)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Abstract

Objective: To evaluate the value of erythropoietin alpha (epoetin) administration, as an alternative treatment of anemia in the operable breast cancer patients.Methods: This is a multicenter phase III randomized clinical trial to evaluate the value of epoetin administration among anemic breast cancer patients who are undergoing anthracyclin-based adjuvant chemotherapy. Sixty four patients were incuded in this trial with initial hemoglobin (Hb) level of 10–12 g/dL. The patients were randomly distributed into two groups: one group received aministration of 40,000 IU epoetin/week for six times a week after operation and the other did not.  In the third week after the operation, both groups were started on a 6 cycles of adjuvant chemotherapy with three weeks intervals. Hb levels were evaluated during every chemotherapy cycle. Results: The Hb levels in the epoetin group were always above 10 g/dL up until the end of the sixth chemotherapy cycle or until the twenty first week post operation without blood transfusion. Conclusions: The administration of epoetin 3 weeks prior and 3 weeks after the first cycles of chemotherapy, maintains a sufficient/normal Hb level in breast cancer patients receiving anthracycline-based chemotherapy.Keywords: Anthracyclin-based chemotherapy, breast cancer, erythropoietin alpha DOI: 10.15850/ijihs.v1n1.102
Strategi Pemakaian Epoetin Alfa dalam Mempertahankan Kadar Hemoglobin pada Kemoterapi Ajuvan Berbasis Antrasiklin Karsinoma Payudara Operabel Dimyati Achmad; Yusuf Hariady; Benny Isakh; Maman Abdurahman
Indonesian Journal of Cancer Vol 7, No 1 (2013): Jan - Mar 2013
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (415.144 KB) | DOI: 10.14414/ijoc.v7i1.277

Abstract

Pada kanker payudara operabel dengan metastasis regional, pemberian kemoterapi ajuvan berbasis antrasiklin dapat menyebabkan terjadinya anemia ringan sampai berat pada sekitar 4% - 63% kasus. Telah dilakukan berbagai penelitian tentang peran epoetin alfa sebagai alternatif pengganti transfusi, tetapi hasilnya masih belum memuaskan. Dilakukan penelitian uji klinik desain paralel dengan randomisasi blok terhadap 64 sampel penelitian yang dibagi atas 2 kelompok, yaitu kelompok perlakuan yang mendapatkan epoetin alfa dan kelompok kontrol. Kadar Hb pasca-operasi yang termasuk dalam kriteria inklusi adalah > 10 gr/dL - 12 gr/dL. Epoetin alfa diberikan 1 minggu pasca-mastektomi diteruskan sampai 6 kali pemberian dengan dosis 40.000 IU/ minggu dan kadar Hb dinilai mulai dari pemberian kemoterapi siklus pertama sampai 3 minggu setelah kemoterapi siklus keenam. Hasil penelitian menunjukkan pemberian epoetin alfa dengan strategi di atas mampu mempertahankan kadar hemoglobin di atas 10 gr/dL dan tidak dibutuhkan transfusi selama kemoterapi. Sedangkan pada kelompok kontrol membutuhkan transfusi sebanyak 28,1% kasus dan kebutuhan transfusi paling banyak terjadi pada kemoterapi siklus keempat. Kesimpulan: strategi pemakaian epoetin alfa yang dapat dipilih adalah mulai 1 minggu pasca-mastektomi yang diteruskan sampai kemoterapi siklus kedua atau 6 kali pemberian dengan dosis 40.000 IU/minggu dan kadar Hb pasca-mastektomi harus > 10 gr/dL - 12 gr/dL.Kata kunci: kanker payudara, anemia, epoetin alfa.
Co-Authors Ahmad Faried Dimyati Achmad Maman Abdurahman Maman Abdurrahman Yusuf Hariady Yusuf Hariady Hariady