{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T06:52:16Z","timestamp":1771051936164,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>Erythropoiesis\u2010stimulating agents (ESAs), such as erythropoietin (EPO) and darbepoetin, may alleviate anemia in diffuse large B\u2010cell lymphoma (DLBCL) patients. However, many cancer cells express EPO receptors (EPOR), through which exogenously administered ESAs potentially promote cancer cell growth. We conducted preclinical\/phase II studies to investigate the safety and efficacy of ESAs for managing chemotherapy\u2010related anemia in DLBCL patients. We examined EPOR expression in germinal center B\u2010cell (GCB)\u2010 and activated B\u2010cell (ABC)\u2010DLBCL cell lines, and investigated the effects of ESAs on cell proliferation, and rituximab\u2010mediated complement\u2010dependent cytotoxicity (CDC). The clinical study enrolled 50 histologically confirmed DLBCL patients receiving rituximab\/cyclophosphamide\/doxorubicin\/vincristine\/prednisolone (R\u2010CHOP) who had hemoglobin levels &lt;10.0 g\/dl after a maximum of three R\u2010CHOP cycles and received \u22654 doses of fixed\u2010dose darbepoetin (360\u2009\u03bcg) once every 3 weeks. <jats:italic>EPOR<\/jats:italic> mRNA was detected in all GCB\u2010DLBCL cell lines, but little\/none was detected in ABC\u2010DLBCL cell lines. GCB\u2010DLBCL and ABC\u2010DLBCL cell proliferation was unaffected by EPO or darbepoetin. Rituximab\u2010mediated CDC of DLBCL cell lines with\/without EPOR expression was not affected adversely by EPO. In the clinical study, baseline mean hemoglobin was 9.19\u2009g\/dl; the overall mean change in hemoglobin was 1.59\u2009\u00b1\u20091.3 g\/dl (16\u2009weeks). Forty\u2010eight percent of enrolled patients achieved a hematopoietic response. Our study shows that ESAs do not affect the growth of DLBCL cells or rituximab\u2010mediated CDC under the experimental conditions that we used, and the appropriate use of ESAs may be effective and safe for DLBCL patients with anemia after R\u2010CHOP.<\/jats:p>","DOI":"10.1002\/ijc.32328","type":"journal-article","created":{"date-parts":[[2019,4,12]],"date-time":"2019-04-12T04:36:44Z","timestamp":1555043804000},"page":"2459-2467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The effects of erythropoiesis\u2010stimulating agents on the management of chemotherapy\u2010induced anemia and tumor growth in diffuse large B\u2010cell lymphoma patients"],"prefix":"10.1002","volume":"145","author":[{"given":"Lee Chun","family":"Park","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Kosin University College of Medicine  Busan South 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