Annals of Hematology

, Volume 96, Issue 5, pp 779–786 | Cite as

Biosimilar epoetin alfa increases haemoglobin levels and brings cognitive and socio-relational benefits to elderly transfusion-dependent multiple myeloma patients: results from a pilot study

  • Roberto Castelli
  • Simona Sciara
  • Giorgio Lambertenghi Deliliers
  • Giuseppe Pantaleo
Original Article


Anaemia is a complication reported in up to 70% of the multiple myeloma patients (MM), with remarkable clinical, cognitive and socio-relational consequences. Anaemia relates to the course of MM, normalizing in patients during remission and reappearing in relapsing/non-responding patients. In a pilot study with 31 patients with MM and transfusion-dependent anaemia, we evaluated the effects of Binocrit (biosimilar epoetin alfa) on transfusions, haemoglobin levels, mental status (mini-mental state evaluation) and the patients’ social-relational functioning and quality of life (QoL). Within a 12-week interval, patients received 40.000 U Binocrit once a week. Binocrit significantly decreased the incidence of transfusion, regardless of the patients’ transfusion history, and significantly increased haemoglobin levels (before-and-after-treatment median haemoglobin values = 8.20 vs. 9.40 g/dl, respectively; Wilcoxon Z test, p < .001). A comparatively greater increment in haemoglobin levels among patients who responded to first vs. additional lines of chemotherapy was also observed. Importantly, we additionally found moderate-to-strong positive associations between increments in haemoglobin levels and corresponding increments both in psychological well-being and QoL (FACT-An scores) and the patients’ cognitive status (mini-mental state evaluation scores). After statistically controlling for possible concurrent benefits of anti-myeloma therapy, increments in haemoglobin levels clearly predicted both increments in socio-relational FACT-An scores (Spearman’s rho = 0.60, p < .001) and in cognitive functioning scores (Spearman’s rho = 0.49, p < .006). Binocrit thus appears as an effective, well-tolerated agent for the management of myeloma anaemia, whose documented benefits include amelioration of anaemia, reduction in transfusion, and improvements in the patients’ social-relational functioning and cognitive well-being.


Multiple myeloma Anaemia Erythroid-stimulating agents (ESAs) Biosimilar epoetin α (Binocrit) Cognitive functioning and psychosocial quality of life (QoL) 


Compliance with ethical standards

The local ethics committee approved the study (N 206 29 June 2013), and all patients gave written informed consent.

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Roberto Castelli
    • 1
  • Simona Sciara
    • 2
  • Giorgio Lambertenghi Deliliers
    • 3
  • Giuseppe Pantaleo
    • 2
  1. 1.Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital MilanUniversity of MilanMilanItaly
  2. 2.UniSR-Social.Lab [Research Methods], Faculty of PsychologySan Raffaele University MilanItaly
  3. 3.Fondazione Mattarelli MilanItaly

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