The effects of erythropoiesis‐stimulating agents on the management of chemotherapy‐induced anemia and tumor growth in diffuse large B‐cell lymphoma patients

Erythropoiesis‐stimulating agents (ESAs), such as erythropoietin (EPO) and darbepoetin, may alleviate anemia in diffuse large B‐cell 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‐related anemia in DLBCL patients. We examined EPOR expression in germinal center B‐cell (GCB)‐ and activated B‐cell (ABC)‐DLBCL cell lines, and investigated the effects of ESAs on cell proliferation, and rituximab‐mediated complement‐dependent cytotoxicity (CDC). The clinical study enrolled 50 histologically confirmed DLBCL patients receiving rituximab/cyclophosphamide/doxorubicin/vincristine/prednisolone (R‐CHOP) who had hemoglobin levels