Efficacy and safety of biosimilar epoetin alpha in patients with chronic lymphoid neoplasms and chemotherapy-induced anaemia: An observational, retrospective, monocentric analysis

Epoetin biosimilars are an alternative to originator erythropoietic agents in the treatment of chemotherapy-induced anaemia; however, their effects in patients with lymphoproliferative disorders remain unclear. This analysis examined the response of patients with lymphoproliferative disorders experiencing chemotherapy-induced anaemia to 4- or 8-week treatment with the biosimilar epoetin alpha. Treatment was initiated at first occurrence of haemoglobin (Hb)<10g/dL during chemotherapy and was stopped when Hb was >11g/dL, when chemotherapy was completed, or in case of transfusion dependency. Response to epoetin alpha was defined as an increase in Hb of >1g/dL or as an Hb>11g/dL. Stability was defined as change in Hb of +/- 1g/dL, and no response was indicated by a decrease in Hb of >1g/dL or acquired transfusion dependence. Overall, 65 patients were enrolled (median age 69years; 47.7%70years old). Mean Hb levels at the initiation of epoetin alpha was 9.3 +/- 0.5g/dL. Mean Hb levels reached 10.7 +/- 1.4 and 10.6 +/- 1.5g/dL at weeks 4 and 8, respectively, in patients on first-line chemotherapy and 11.4 +/- 1.6 and 9.7 +/- 1.3g/dL in those on a second- or higher-line regimen. Overall, 70.8% of patients responded, 26.1% had stable Hb, and 3.1% did not respond. Delays or interruption of any chemotherapy cycle due to anaemia occurred in 18 patients. The biosimilar epoetin alpha was well tolerated and allowed patients with non-Hodgkin lymphoma or chronic lymphoproliferative disorders to continue their course of chemotherapy by effectively increasing and maintaining adequate concentrations of Hb.