Growth Factors
Return to Q&A Library Procrit / Epogen
Starting Procrit Treatment
Procrit Side Effects
Success Rates of Procrit
Procrit Given With Other Medicines
Darbepoetin and Pegfilgrastim
Neupogen and Blast Count
Platelet Counts
Procrit / Epogen
What kind of medication is Procrit?
Procrit or Epogen are brand names for A man-made version of a naturally occurring substance in the body (erythropoietin) that encourages the bone marrow to make more red blood cells. Epoetin alfa can help improve red blood cell counts in bone marrow failure disease patients whose natural erythropoietin levels are low. It is given by injection under the skin (subcutaneous) or in the vein (intravenous). Epoetin alfa is approved by the U.S. Food and Drug Administration (FDA) for treating anemia. It is in a class of drugs called growth factors (cytokines).
epoetin alfa (ih-POH-ee-tin), a man-made version of human erythropoietin (EPO). EPO is produced naturally in the body, mostly by the kidneys. It stimulates the The soft, spongy tissue inside most bones. Blood cells are formed in the bone marrow.
bone marrow to produce The most numerous type of blood cell in healthy people. Red blood cells contain hemoglobin, a protein that picks up oxygen in the lungs and brings it to cells in all parts of the body. Also called erythrocyte, RBC.
red blood cells. It is approved by the U.S. Food and Drug Administration (FDA) for use in patients with kidney disease. EPO has been helpful for treating (ay-PLASS-tik uh-NEE_mee-uh) A rare and serious condition in which the bone marrow fails to make enough blood cells: red blood cells, white blood cells, and platelets. The term aplastic is a Greek word meaning not to form. Anemia is a condition that happens when red blood cell count is low. Most scientists believe that aplastic anemia happens when the immune system attacks the bone marrow stem cells. Aplastic anemia can be acquired (begin any time in life) or can be hereditary (less common, passed down from parent to child).
anemia in some patients with MDS, although there is still need to define more exactly which subset of patients are most likely to benefit. EPO may be helpful, but much more rarely, also in patients with aplastic anemia or PNH.
Starting Procrit Treatment
When is Procrit usually started in MDS patients?
The objective of treatment is to reduce (ay-PLASS-tik uh-NEE_mee-uh) A rare and serious condition in which the bone marrow fails to make enough blood cells: red blood cells, white blood cells, and platelets. The term aplastic is a Greek word meaning not to form. Anemia is a condition that happens when red blood cell count is low. Most scientists believe that aplastic anemia happens when the immune system attacks the bone marrow stem cells. Aplastic anemia can be acquired (begin any time in life) or can be hereditary (less common, passed down from parent to child).
anemia (improve A protein in the red blood cells. Hemoglobin picks up oxygen in the lungs and brings it to cells in all parts of the body.
hemoglobin levels) or to eliminate transfusion requirements. A man-made version of a naturally occurring substance in the body (erythropoietin) that encourages the bone marrow to make more red blood cells. Epoetin alfa can help improve red blood cell counts in bone marrow failure disease patients whose natural erythropoietin levels are low. It is given by injection under the skin (subcutaneous) or in the vein (intravenous). Epoetin alfa is approved by the U.S. Food and Drug Administration (FDA) for treating anemia. It is in a class of drugs called growth factors (cytokines).
Erythropoietin is usually more effective in patients who are not yet transfusion-dependent. Recombinant erythropoietin, marketed as Procrit or Epogen in the U.S. (Eprex in Canada), is given as a subcutaneous (under the skin) injection usually in the upper arms, thighs or abdomen or in other sites into the soft tissue under the skin. The dosage varies greatly in different studies, 50-600 units/kg three times a week initially, then tapered for long-term use. The dose may be individualized depending on the patient's symptoms and response to the drug.
Procrit Side Effects
What are the side effects of Procrit?
The most common side effects of A man-made version of a naturally occurring substance in the body (erythropoietin) that encourages the bone marrow to make more red blood cells. Epoetin alfa can help improve red blood cell counts in bone marrow failure disease patients whose natural erythropoietin levels are low. It is given by injection under the skin (subcutaneous) or in the vein (intravenous). Epoetin alfa is approved by the U.S. Food and Drug Administration (FDA) for treating anemia. It is in a class of drugs called growth factors (cytokines).
Procrit for patients with cancer include: fever, diarrhea, nausea, fluid retention (edema), weakness, fatigue, high blood pressure, shortness of breath and muscle pains. Many of these same symptoms may occur in patients with the same disease who are NOT being treated with Procrit. Side effects directly related to erythropoietin (Procrit/Epogen) are uncommon, such as allergic reaction.
Success Rates of Procrit
How long have Procrit shots been used for treating anemia in myelodysplastic (MDS) patients? What is the success rate?
A man-made version of a naturally occurring substance in the body (erythropoietin) that encourages the bone marrow to make more red blood cells. Epoetin alfa can help improve red blood cell counts in bone marrow failure disease patients whose natural erythropoietin levels are low. It is given by injection under the skin (subcutaneous) or in the vein (intravenous). Epoetin alfa is approved by the U.S. Food and Drug Administration (FDA) for treating anemia. It is in a class of drugs called growth factors (cytokines).
Epoetin alfa (Procrit or Epogen) has been used for MDS since about 1990. The benefit varies among patients. Some patients have no benefit at all. The reported response rate varies from 10-50% from study to study. Dosage for treating MDS patients with anemia should be 80,000 to 90,000 units per week, or 150-300 units per kilo per day. For patients who do not respond to adequate dosage of Epoetin, G-CSF or GM-CSF can be added (Leukine or Neupogen).
Epoetin stimulates production of young red blood cells (reticulocytes) within 3 to 7 days. A definite rise in A protein in the red blood cells. Hemoglobin picks up oxygen in the lungs and brings it to cells in all parts of the body.
hemoglobin requires longer (2-4 weeks). The maximum rise in the hemoglobin requires several months. However, in many patients with aplastic anemia the shortage of Cells in the body that develop into other cells. There are two main sources of stem cells. Embryonic stem cells come from human embryos and are used in medical research. Adult stem cells in the body repair and maintain the organ or tissue in which they are found. Blood-forming (hemapoietic) stem cells are found in the bone marrow. These cells make copies of themselves and develop into red cells, white cells, and platelets.
stem cells is so severe that there is little left to stimulate, and EPO may work very little, if at all.
Responses to Procrit or Epogen are measured by the hemoglobin level and by monitoring the frequency of The most numerous type of blood cell in healthy people. Red blood cells contain hemoglobin, a protein that picks up oxygen in the lungs and brings it to cells in all parts of the body. Also called erythrocyte, RBC.
red blood cells transfusions. An improved hemoglobin level is strongly correlated with less fatigue.
Patients who have relatively low serum erythropoietin levels before treatment are more likely to respond to erythropoietin. It is important for doctors to test the serum erythropoietin level in MDS patients.
Procrit Given With Other Medicines
Are other medicines given in combination with Procrit?
Procrit or Epogen is usually given alone. Low doses of Neupogen (A man-made version of a naturally occurring substance in the body that promotes white blood cell growth in the bone marrow. It is known as a hematopoietic growth factor or colony stimulating factorand is given by injection under the skin (subcutaneous) or in the vein (intravenous). Filgrastim is approved by the U.S. Food and Drug Administration (FDA) for use in cancer patients who are at risk of developing infection due to cancer treatment. It is also approved for treating other patients who have a very low white blood cell count. It is in a class of drugs called growth factors (cytokines).
G-CSF, granulocyte colony stimulating factor) have been reported to improve the effectiveness of Procrit, but this has not been clearly validated in a prospective randomized trial. Other medications such as amifostine or retinoic acid derivitives can be given in combination with Procrit. Procrit has little effect on the levels of other blood counts (white cells and platelets). These other counts may be improved by different medications.
Darbepoetin and Pegfilgrastim
What kind of experience is there in using darbepoetin (Aranesp) and pegfilgrastim (Neulasta) in patients with MDS?
These are longer lasting formulations of A man-made version of a naturally occurring substance in the body (erythropoietin) that encourages the bone marrow to make more red blood cells. Epoetin alfa can help improve red blood cell counts in bone marrow failure disease patients whose natural erythropoietin levels are low. It is given by injection under the skin (subcutaneous) or in the vein (intravenous). Epoetin alfa is approved by the U.S. Food and Drug Administration (FDA) for treating anemia. It is in a class of drugs called growth factors (cytokines).
epoetin alfa, which is used to stimulate the bone marrow to make red blood cells, and A man-made version of a naturally occurring substance in the body that promotes white blood cell growth in the bone marrow. It is known as a hematopoietic growth factor or colony stimulating factorand is given by injection under the skin (subcutaneous) or in the vein (intravenous). Filgrastim is approved by the U.S. Food and Drug Administration (FDA) for use in cancer patients who are at risk of developing infection due to cancer treatment. It is also approved for treating other patients who have a very low white blood cell count. It is in a class of drugs called growth factors (cytokines).
G-CSF, which stimulates the bone marrow to make white blood cells. A growth factor (cytokine), it is a man-made version of a naturally occurring substance in the body, called erythropoietin, that encourages the bone marrow to make more red blood cells. It is in a class of medicines called erythropoiesis-stimulating agents (ESAs). Darbepoetin alfa can help improve red blood cell counts in bone marrow failure patients whose natural erythropoietin levels are low. It is given by injection under the skin (subcutaneous) or in the vein (intravenous). Darbepoetin alfa is approved by the U.S. Food and Drug Administration (FDA) for treating anemia.
Darbepoetin alfa and pegfilgrastim can be given less frequently that their counterparts. They are approved for patients undergoing cancer chemotherapy, and darbepoietin for the chronic anemia associated with renal failure. Both agents are relatively new and experience in treating (ay-PLASS-tik uh-NEE_mee-uh) A rare and serious condition in which the bone marrow fails to make enough blood cells: red blood cells, white blood cells, and platelets. The term aplastic is a Greek word meaning not to form. Anemia is a condition that happens when red blood cell count is low. Most scientists believe that aplastic anemia happens when the immune system attacks the bone marrow stem cells. Aplastic anemia can be acquired (begin any time in life) or can be hereditary (less common, passed down from parent to child).
anemia due to MDS is limited. There is no reason to think that they would be more (or less) effective than the "parent" drugs (A man-made version of a naturally occurring substance in the body (erythropoietin) that encourages the bone marrow to make more red blood cells. Epoetin alfa can help improve red blood cell counts in bone marrow failure disease patients whose natural erythropoietin levels are low. It is given by injection under the skin (subcutaneous) or in the vein (intravenous). Epoetin alfa is approved by the U.S. Food and Drug Administration (FDA) for treating anemia. It is in a class of drugs called growth factors (cytokines).
epoetin alfa and A man-made version of a naturally occurring substance in the body that promotes white blood cell growth in the bone marrow. It is known as a hematopoietic growth factor or colony stimulating factorand is given by injection under the skin (subcutaneous) or in the vein (intravenous). Filgrastim is approved by the U.S. Food and Drug Administration (FDA) for use in cancer patients who are at risk of developing infection due to cancer treatment. It is also approved for treating other patients who have a very low white blood cell count. It is in a class of drugs called growth factors (cytokines).
filgrastim).
Neupogen and blast count
Does the use of Neupogen for increasing white blood cell counts in MDS patients have a negative effect on blasts?
This is somewhat controversial. In most series there has NOT been an increased frequency or rate of developing leukemia. In theory both A young white blood cell. The number of blast cells in the bone marrow helps define how severe MDS is in a person. When 20 out of 100 cells in the bone marrow are blasts, this is considered acute myeloid leukemia.
blast cells and normal cells can grow in response to Neupogen. Leukemia cells in specific patients may proliferate more rapidly in the presence of A man-made version of a naturally occurring substance in the body that promotes white blood cell growth in the bone marrow. It is known as a hematopoietic growth factor or colony stimulating factorand is given by injection under the skin (subcutaneous) or in the vein (intravenous). Filgrastim is approved by the U.S. Food and Drug Administration (FDA) for use in cancer patients who are at risk of developing infection due to cancer treatment. It is also approved for treating other patients who have a very low white blood cell count. It is in a class of drugs called growth factors (cytokines).
G-CSF.
G-CSF (Neupogen) will often increase the percentage of circulating blasts. This effect is usually reversible. In some patients, G-CSF may decrease the percentage of blasts by inducing maturation of these cells. This effect is also usually reversible. It is not clear whether there are long-term effects of G-CSF use. A randomized trial in which neutropenic MDS patients received G-CSF or observation showed improved survival in patients who DID NOT receive G-CSF. This was because more patients in the G-CSF arm had significantly more problems with low platelets and bleeding. This may be a consequence of G-SCF therapy.
Platelet Counts
Is there a medication to improve platelet counts in aplastic anemia or MDS patients? Are there any foods or herbs to help platelet counts?
A man-made version of a naturally occurring substance in the body (erythropoietin) that encourages the bone marrow to make more red blood cells. Epoetin alfa can help improve red blood cell counts in bone marrow failure disease patients whose natural erythropoietin levels are low. It is given by injection under the skin (subcutaneous) or in the vein (intravenous). Epoetin alfa is approved by the U.S. Food and Drug Administration (FDA) for treating anemia. It is in a class of drugs called growth factors (cytokines).
Erythropoietin is the cytokine that keeps the red blood cell series going and A man-made version of a naturally occurring substance in the body that promotes white blood cell growth in the bone marrow. It is known as a hematopoietic growth factor or colony stimulating factorand is given by injection under the skin (subcutaneous) or in the vein (intravenous). Filgrastim is approved by the U.S. Food and Drug Administration (FDA) for use in cancer patients who are at risk of developing infection due to cancer treatment. It is also approved for treating other patients who have a very low white blood cell count. It is in a class of drugs called growth factors (cytokines).
G-CSF, or granulocyte colony stimulating factor, is the cytokine that helps the The soft, spongy tissue inside most bones. Blood cells are formed in the bone marrow.
bone marrow make Cells in the body that fight disease and infection by attacking and killing germs. There are several types of white blood cells including neutrophils, eosinophils, basophils, lymphocytes and monocytes. Each type of cell fights a different kind of germ. Also called WBC, leukocyte.
white blood cells.
Several cytokines are being developed that may improve The smallest type of blood cell. Platelets help the blood to clot and stop bleeding. Also called a thrombocyte.
platelet counts. Although they help to decrease (throm-buh-sie-tuh-PEE-nee-uh) A condition in which there is a shortage of platelets in the bloodstream. This results in a low platelet count. Bleeding and bruising often occur with thrombocytopenia.
thrombocytopenia after chemotherapy, they have not been very effective in patients with aplastic anemia or myelodysplastic syndromes. The problem with using a cytokine in someone with bone marrow failure is that the bone marrow is intrinsically disordered. The cytokine can "talk" to the bone marrow but the marrow may not be able to respond.
No foods, herbs, or supplements will improve the platelet count.
