Ludwig H
First Department of Medicine and Medical Oncology, Wilhelminenspital, Vienna, Austria.
Nephrol Dial Transplant. 1999;14 Suppl 2:85-92. doi: 10.1093/ndt/14.suppl_2.85.
Cancer-related anaemia has a number of causes, not least the underlying malignancy itself which plays a role in suppressing erythropoiesis. Anaemia is often exacerbated by cancer treatments, in particular routinely used cytotoxic chemotherapy. Chronic anaemia of cancer is often characterized by inappropriately low levels of endogenous erythropoietin for the degree of anaemia, and manifests clinically with generalized hypoxia and resultant severe fatigue. Epoetin alfa is one recombinant form of erythropoietin, the primary human growth factor responsible for promoting proliferation and survival of erythroid progenitor cells. Epoetin alfa has been widely studied for the treatment of anaemia associated with renal failure and is now recognized as having significant potential in the management of cancer-related anaemia. Studies suggest that epoetin alfa is an effective treatment in a proportion of cancer patients with symptomatic anaemia. It also appears useful for the prevention of chemotherapy-induced anaemia. Studies in a number of different cancer settings have shown that epoetin alfa significantly increases haemoglobin and haematocrit, reduces transfusion requirements and improves quality of life for the patient.
癌症相关性贫血有多种病因,其中最主要的是潜在的恶性肿瘤本身,它在抑制红细胞生成中起作用。贫血常因癌症治疗而加重,尤其是常规使用的细胞毒性化疗。癌症相关性慢性贫血的特征通常是,就贫血程度而言,内源性促红细胞生成素水平过低,临床症状表现为全身缺氧及由此导致的严重疲劳。促红细胞生成素α是促红细胞生成素的一种重组形式,促红细胞生成素是主要的人类生长因子,负责促进红系祖细胞的增殖和存活。促红细胞生成素α已被广泛研究用于治疗与肾衰竭相关的贫血,目前被认为在癌症相关性贫血的管理中具有巨大潜力。研究表明,促红细胞生成素α对一部分有症状性贫血的癌症患者是一种有效的治疗方法。它似乎对预防化疗引起的贫血也有用。在许多不同癌症背景下的研究表明,促红细胞生成素α能显著提高血红蛋白和血细胞比容,减少输血需求,并改善患者的生活质量。