Handbook of Cancer Chemotherapy (Lippincott Williams & Wilkins Handbook Series) by Skeel Roland T. & Khlief Samir N

Author:Skeel, Roland T. & Khlief, Samir N. [Skeel, Roland T.]
Language: eng
Format: epub
Publisher: Lippincot (Wolters Kluwer Health)
Published: 2012-06-28T00:00:00+00:00

a. Anemia. Androgens (e.g., testosteroneenanthate 600 mg intramuscularly weekly or fluoxymesterone 10 mg by mouth two or three times a day for men; danazol 400 to 600 mg by mouth daily for women) are recommended and reduce transfusion requirements in 30% to 50% of patients. Corticosteroids (e.g., prednisone 40 mg/m2 by mouth daily) should be tried if overt hemolysis is present. Erythropoietin is helpful in a small percent of patients but requires large doses; response is unlikely if serum erythropoietin level is greater than 200 mU/mL. In limited studies, improvement in cytopenias or transfusion requirements has been reported in 20% to 50% of patients with PMF receiving low-dose thalidomide (50 mg/day) or lenalidomide (5 to 10 mg/day).

PMF patients routinely become transfusion-dependent; early institution of iron-chelating agents is advisable.

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