A retrospective cohort study to assess the impact of therapeutic substitution of darbepoetin alfa for epoetin alfa in anemic patients with myelodysplastic syndrome.

Darbepoetin alfa and epoetin alfa are used to treat anemia in the undertreated population of patients with myelodysplastic syndrome (MDS). We implemented guidelines to switch anemic patients with MDS from epoetin alfa 40,000 U weekly to darbepoetin alfa 200 microg every 2 weeks and then conducted a retrospective cohort study of the initial 263 treated patients. Patients (> or = 18 years old, MDS diagnosis) were either previously treated with epoetin alfa (received 16 weeks of prior epoetin alfa and either switched to darbepoetin alfa or remained on epoetin alfa) or treatment-naive (no previous erythropoietin therapy and received only 1 agent for 16 weeks).