Biosimilar erythropoiesis‐stimulating agents are an effective and safe option for the management of myelofibrosis‐related anemia. (16th December 2022)

• Record Type: Journal Article
• Authors: Inzoli, Elena; Crisà, Elena; Pugliese, Novella; Civettini, Ivan; Lanzarone, Giuseppe; Castelli, Andrea; Martinelli, Vincenzo; Montelisciani, Laura; Antolini, Laura; Gambacorti‐Passerini, Carlo; Elli, Elena Maria
• Is Part Of: European journal of haematology. Volume 110:Number 4(2023)
• Page Start: 354
• Page End: 361
• Publication Date: 2022-12-16
• Subjects: anemia -- biosimilar pharmaceuticals -- erythropoiesis‐stimulating agents -- Janus kinase inhibitors -- myelofibrosis -- outcome; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.13910
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: Objectives: Erythropoiesis‐stimulating agents (ESA) have an established role in treating anemia in hematological malignancies. However, their role, particularly biosimilar ESA (B‐ESA), in myelofibrosis (MF) is not well established. Methods: This study retrospectively collected data on 96 MF patients treated with B‐ESA (alpha/zeta) for the management of anemia to assess safety, efficacy (anemia response [AR]), and survival. Results: Seventy‐seven patients (80%) obtained AR. The median time to AR was 2.5 months. In multivariate analysis, significant predictive factors of AR were transfusion independency ( p = .006) and ferritin levels <200 ng/ml ( p = .009) at baseline. After a median follow‐up of 43.8 months from diagnosis, 38 patients (39%) died, 11 (28.9%) from leukemic evolution. Only two patients (2.5%) stopped B‐ESA for toxicity. The 24‐month survival was significantly affected by response to B‐ESA (70.8% in AR vs. 55.3% in non‐responder patients, p = .016). In multivariate analysis, age ≤ 70 years ( p = .029) and Hb > 8.5 g/dl ( p = .047) at baseline were significantly associated with improved survival, with a trend for longer survival in AR patients ( p = .06). Conclusions: B‐ESA seems to be an effective and well‐tolerated option for anemia treatment in the MF setting. This strategy deserves further clinical investigation.