Cella David
Center on Outcomes Research and Education, Evanston Northwestern Healthcare, Illinois, USA.
Oncology (Williston Park). 2002 Sep;16(9 Suppl 10):125-32.
Anemia, common in people with cancer, can be due to the disease itself or to the associated therapy. Fatigue, the most prevalent of all symptoms experienced by cancer patients, is the primary symptom of anemia. Caused by many factors,fatigue, regardless of etiology, has an adverse impact on health-related quality of life. Anemia is among the more treatable of those causes. Prior to the development of recombinant human erythropoietin, red blood cell transfusion was the standard treatment for cancer-related anemia. Erythropoietic agents are an effective alternative to blood transfusion: they improve hematocrit, reduce transfusion dependency, and eliminate transfusion-related risks. Although studies are mixed, most clinical trials have also suggested that erythropoietic agents have a positive impact upon cancer patients' quality of life. However, the cost of drug supply is quite high in the oncology setting, where much higher doses are required relative to the nephrology setting. Thus, although few challenge the treatment's effectiveness, cost-effectiveness remains an open question. The data collected over the years to address these questions have helped define and clarify the relationship between anemia and health-related quality of life in people with cancer. That relationship is summarized in this article.
贫血在癌症患者中很常见，可能是由疾病本身或相关治疗引起的。疲劳是癌症患者经历的所有症状中最普遍的，是贫血的主要症状。疲劳由多种因素引起，无论病因如何，都会对健康相关生活质量产生不利影响。贫血是这些病因中较易治疗的一种。在重组人促红细胞生成素研发出来之前，红细胞输血是治疗癌症相关贫血的标准方法。促红细胞生成剂是输血的有效替代方法：它们可提高血细胞比容，减少输血依赖，并消除与输血相关的风险。尽管研究结果不一，但大多数临床试验也表明促红细胞生成剂对癌症患者的生活质量有积极影响。然而，在肿瘤学环境中，药物供应成本相当高，相对于肾脏病学环境需要更高的剂量。因此，尽管很少有人质疑该治疗方法的有效性，但成本效益仍是一个悬而未决的问题。多年来收集的用于解决这些问题的数据有助于明确和阐明癌症患者贫血与健康相关生活质量之间的关系。本文总结了这种关系。
