Modeling of treatment response to erythropoiesis-stimulating agents in older (age≥70years) and younger (age<70years) patients with cancer and anemia: Findings from the Anemia Cancer Treatment study

Ivo L Abraham, Karen MacDonald, Soba Tharmarajah, Carsten Bokemeyer, Heinz Ludwig, Pierre Soubeyran, Vittorio Battistel, Matti Aapro

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: The Anemia Cancer Treatment study assessed hemoglobin (Hb) outcomes following treatment with erythropoiesis-stimulating agents (ESA) in anemic (Hb ≤ 11. g/dL) patients in Europe. We replicated the original analyses stratifying by age, namely patients aged ≥ 70 (n. =637) versus those aged < 70 (n. =1555). Materials and methods: A secondary analysis of Hb outcomes was assessed over 8-10. weeks. Treatment response criteria included increases of Hb ≥ 1. g/dL, Hb ≥ 1. g/dL over 8. weeks, and Hb ≥ 2. g/dL over the course of the study period. Results: Mean Hb increased from similar levels of 9.5. g/dL [p. =not significant (ns)] at visit one to 10.9. g/dL (p. =ns) at visit three (both p < 0.001). Patients aged ≥ 70 had higher mean Hb at visit two (10.6. g/dL vs. 10.3. g/dL, p < 0.001). Cohorts did not differ in treatment response rates (all p. =ns). Mean performance status differed between cohorts at each visit (all p ≤ 0.011); both groups showed significant improvements (both p < 0.001). Immediacy of response was a consistent determinant but was more pronounced among patients aged ≥ 70. Less consistent determinants included performance status in the age ≥ 70 group, as well as hematological malignancy and Hb at ESA start in the age < 70 group. The proportion of variance in Hb outcomes attributable to treatment center ranged from 0.090 to 0.289 in the age ≥ 70 cohort and 0.126 to 0.361 in the age < 70 cohort. Conclusions: Both groups achieved similar Hb levels with the age ≥ 70 cohort showing a higher initial evolution rate and potentially a different Hb response trajectory. Patients age ≥ 70 were more likely to benefit from ESAs if showing an early erythropoietic response and exhibiting no or little impairment in performance status. Differential attribution of variability in older vs. younger adults suggests that individualization of ESA therapy may facilitate Hb response in geriatric patients with cancer.

Original languageEnglish (US)
Pages (from-to)196-201
Number of pages6
JournalJournal of Geriatric Oncology
Volume4
Issue number2
DOIs
StatePublished - Apr 2013

Fingerprint

Hematinics
Anemia
Hemoglobins
Neoplasms
Therapeutics
Hematologic Neoplasms
Geriatrics

Keywords

  • Anemia
  • Elderly
  • Erythropoietin
  • Geriatric oncology
  • Hemoglobin
  • Outcomes

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Oncology

Cite this

Modeling of treatment response to erythropoiesis-stimulating agents in older (age≥70years) and younger (age<70years) patients with cancer and anemia : Findings from the Anemia Cancer Treatment study. / Abraham, Ivo L; MacDonald, Karen; Tharmarajah, Soba; Bokemeyer, Carsten; Ludwig, Heinz; Soubeyran, Pierre; Battistel, Vittorio; Aapro, Matti.

In: Journal of Geriatric Oncology, Vol. 4, No. 2, 04.2013, p. 196-201.

Research output: Contribution to journalArticle

Abraham, Ivo L ; MacDonald, Karen ; Tharmarajah, Soba ; Bokemeyer, Carsten ; Ludwig, Heinz ; Soubeyran, Pierre ; Battistel, Vittorio ; Aapro, Matti. / Modeling of treatment response to erythropoiesis-stimulating agents in older (age≥70years) and younger (age<70years) patients with cancer and anemia : Findings from the Anemia Cancer Treatment study. In: Journal of Geriatric Oncology. 2013 ; Vol. 4, No. 2. pp. 196-201.
@article{bac970dcc2784abc9dba8b7e7d228efa,
title = "Modeling of treatment response to erythropoiesis-stimulating agents in older (age≥70years) and younger (age<70years) patients with cancer and anemia: Findings from the Anemia Cancer Treatment study",
abstract = "Introduction: The Anemia Cancer Treatment study assessed hemoglobin (Hb) outcomes following treatment with erythropoiesis-stimulating agents (ESA) in anemic (Hb ≤ 11. g/dL) patients in Europe. We replicated the original analyses stratifying by age, namely patients aged ≥ 70 (n. =637) versus those aged < 70 (n. =1555). Materials and methods: A secondary analysis of Hb outcomes was assessed over 8-10. weeks. Treatment response criteria included increases of Hb ≥ 1. g/dL, Hb ≥ 1. g/dL over 8. weeks, and Hb ≥ 2. g/dL over the course of the study period. Results: Mean Hb increased from similar levels of 9.5. g/dL [p. =not significant (ns)] at visit one to 10.9. g/dL (p. =ns) at visit three (both p < 0.001). Patients aged ≥ 70 had higher mean Hb at visit two (10.6. g/dL vs. 10.3. g/dL, p < 0.001). Cohorts did not differ in treatment response rates (all p. =ns). Mean performance status differed between cohorts at each visit (all p ≤ 0.011); both groups showed significant improvements (both p < 0.001). Immediacy of response was a consistent determinant but was more pronounced among patients aged ≥ 70. Less consistent determinants included performance status in the age ≥ 70 group, as well as hematological malignancy and Hb at ESA start in the age < 70 group. The proportion of variance in Hb outcomes attributable to treatment center ranged from 0.090 to 0.289 in the age ≥ 70 cohort and 0.126 to 0.361 in the age < 70 cohort. Conclusions: Both groups achieved similar Hb levels with the age ≥ 70 cohort showing a higher initial evolution rate and potentially a different Hb response trajectory. Patients age ≥ 70 were more likely to benefit from ESAs if showing an early erythropoietic response and exhibiting no or little impairment in performance status. Differential attribution of variability in older vs. younger adults suggests that individualization of ESA therapy may facilitate Hb response in geriatric patients with cancer.",
keywords = "Anemia, Elderly, Erythropoietin, Geriatric oncology, Hemoglobin, Outcomes",
author = "Abraham, {Ivo L} and Karen MacDonald and Soba Tharmarajah and Carsten Bokemeyer and Heinz Ludwig and Pierre Soubeyran and Vittorio Battistel and Matti Aapro",
year = "2013",
month = "4",
doi = "10.1016/j.jgo.2012.09.058",
language = "English (US)",
volume = "4",
pages = "196--201",
journal = "Journal of Geriatric Oncology",
issn = "1879-4068",
publisher = "Elsevier Limited",
number = "2",

}

TY - JOUR

T1 - Modeling of treatment response to erythropoiesis-stimulating agents in older (age≥70years) and younger (age<70years) patients with cancer and anemia

T2 - Findings from the Anemia Cancer Treatment study

AU - Abraham, Ivo L

AU - MacDonald, Karen

AU - Tharmarajah, Soba

AU - Bokemeyer, Carsten

AU - Ludwig, Heinz

AU - Soubeyran, Pierre

AU - Battistel, Vittorio

AU - Aapro, Matti

PY - 2013/4

Y1 - 2013/4

N2 - Introduction: The Anemia Cancer Treatment study assessed hemoglobin (Hb) outcomes following treatment with erythropoiesis-stimulating agents (ESA) in anemic (Hb ≤ 11. g/dL) patients in Europe. We replicated the original analyses stratifying by age, namely patients aged ≥ 70 (n. =637) versus those aged < 70 (n. =1555). Materials and methods: A secondary analysis of Hb outcomes was assessed over 8-10. weeks. Treatment response criteria included increases of Hb ≥ 1. g/dL, Hb ≥ 1. g/dL over 8. weeks, and Hb ≥ 2. g/dL over the course of the study period. Results: Mean Hb increased from similar levels of 9.5. g/dL [p. =not significant (ns)] at visit one to 10.9. g/dL (p. =ns) at visit three (both p < 0.001). Patients aged ≥ 70 had higher mean Hb at visit two (10.6. g/dL vs. 10.3. g/dL, p < 0.001). Cohorts did not differ in treatment response rates (all p. =ns). Mean performance status differed between cohorts at each visit (all p ≤ 0.011); both groups showed significant improvements (both p < 0.001). Immediacy of response was a consistent determinant but was more pronounced among patients aged ≥ 70. Less consistent determinants included performance status in the age ≥ 70 group, as well as hematological malignancy and Hb at ESA start in the age < 70 group. The proportion of variance in Hb outcomes attributable to treatment center ranged from 0.090 to 0.289 in the age ≥ 70 cohort and 0.126 to 0.361 in the age < 70 cohort. Conclusions: Both groups achieved similar Hb levels with the age ≥ 70 cohort showing a higher initial evolution rate and potentially a different Hb response trajectory. Patients age ≥ 70 were more likely to benefit from ESAs if showing an early erythropoietic response and exhibiting no or little impairment in performance status. Differential attribution of variability in older vs. younger adults suggests that individualization of ESA therapy may facilitate Hb response in geriatric patients with cancer.

AB - Introduction: The Anemia Cancer Treatment study assessed hemoglobin (Hb) outcomes following treatment with erythropoiesis-stimulating agents (ESA) in anemic (Hb ≤ 11. g/dL) patients in Europe. We replicated the original analyses stratifying by age, namely patients aged ≥ 70 (n. =637) versus those aged < 70 (n. =1555). Materials and methods: A secondary analysis of Hb outcomes was assessed over 8-10. weeks. Treatment response criteria included increases of Hb ≥ 1. g/dL, Hb ≥ 1. g/dL over 8. weeks, and Hb ≥ 2. g/dL over the course of the study period. Results: Mean Hb increased from similar levels of 9.5. g/dL [p. =not significant (ns)] at visit one to 10.9. g/dL (p. =ns) at visit three (both p < 0.001). Patients aged ≥ 70 had higher mean Hb at visit two (10.6. g/dL vs. 10.3. g/dL, p < 0.001). Cohorts did not differ in treatment response rates (all p. =ns). Mean performance status differed between cohorts at each visit (all p ≤ 0.011); both groups showed significant improvements (both p < 0.001). Immediacy of response was a consistent determinant but was more pronounced among patients aged ≥ 70. Less consistent determinants included performance status in the age ≥ 70 group, as well as hematological malignancy and Hb at ESA start in the age < 70 group. The proportion of variance in Hb outcomes attributable to treatment center ranged from 0.090 to 0.289 in the age ≥ 70 cohort and 0.126 to 0.361 in the age < 70 cohort. Conclusions: Both groups achieved similar Hb levels with the age ≥ 70 cohort showing a higher initial evolution rate and potentially a different Hb response trajectory. Patients age ≥ 70 were more likely to benefit from ESAs if showing an early erythropoietic response and exhibiting no or little impairment in performance status. Differential attribution of variability in older vs. younger adults suggests that individualization of ESA therapy may facilitate Hb response in geriatric patients with cancer.

KW - Anemia

KW - Elderly

KW - Erythropoietin

KW - Geriatric oncology

KW - Hemoglobin

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=84875607397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875607397&partnerID=8YFLogxK

U2 - 10.1016/j.jgo.2012.09.058

DO - 10.1016/j.jgo.2012.09.058

M3 - Article

C2 - 24071545

AN - SCOPUS:84875607397

VL - 4

SP - 196

EP - 201

JO - Journal of Geriatric Oncology

JF - Journal of Geriatric Oncology

SN - 1879-4068

IS - 2

ER -