Combination therapy with granulocyte colony-stimulating factor (G-CSF) and erythropoietin (EPO) has been used with the aim of accelerating the recovery of red blood cells following autologous bone marrow transplantation. Previous studies have shown, however, that this practice has no significant effect on erythroid recovery and transfusional requirements.
Where there could be some benefit is in the reduced intensity transplant setting where EPO responsive erythroid precursor may persist following conditioning. The problem is that evidence in the shape of prospective studies is lacking.
Because of the limited number and mixed results of studies, the use of erythropoietin and G-CSF in combination is not generally accepted and experience with biosimilars is therefore lacking.
Erythropoietin may also be used to treat anaemia (haemoglobin > 10 to ≤ 13 g/dL). However, use of erythropoietin in healthy donors of stem cells to maintain haematocrit levels, is generally not allowed. The concern in this setting is that unexpected toxicity might have a detrimental effect and so the use of biosimilar epoetins for this indication is not recommended. There is no experience reported in the literature.
Conflict of interest
The author of the research paper did not declare any conflict of interest.
Editor’s comment
There is a lack of evidence for the use of biosimilar erythropoietin in the indications discussed in this paper. If you are interested in contributing a research paper in this area to GaBI Journal, please send us your submission here.
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