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每周一次的β-促红细胞生成素对治疗患有淋巴增生性恶性肿瘤且内源性促红细胞生成素产生缺陷的贫血患者非常有效。

Once-weekly epoetin beta is highly effective in treating anaemic patients with lymphoproliferative malignancy and defective endogenous erythropoietin production.

作者信息

Cazzola Mario, Beguin Yves, Kloczko Janusz, Spicka Ivan, Coiffier Bertrand

机构信息

Division of Haematology, University of Pavia Medical School, Pavia, Italy.

出版信息

Br J Haematol. 2003 Aug;122(3):386-93. doi: 10.1046/j.1365-2141.2003.04439.x.

Abstract

Epoetin beta, three-times weekly (t.i.w.), is effective in reversing anaemia in lymphoproliferative disorders. The current study investigated whether an epoetin beta dose of 30,000 IU given subcutaneously once weekly (q.w.) was at least as effective as 10,000 t.i.w. administration in anaemic patients with lymphoproliferative malignancy and defective endogenous erythropoietin (Epo) production. Overall, 241 anaemic patients with multiple myeloma, low-grade non-Hodgkin's lymphoma or chronic lymphocytic leukaemia, all with serum Epo values </= 100 mU/ml, were randomized to receive the q.w. (n = 119) or t.i.w. (n = 122) regimen for 16 weeks. The primary efficacy criterion, i.e. the time-adjusted area under the haemoglobin-time curve from weeks 5-16, was comparable between the q.w. and t.i.w. groups [difference = - 0.20 g/dl (90% confidence interval - 0.52-0.11)]. Moreover, response rates were high and similar in both arms (72%vs 75%, q.w. and t.i.w. groups respectively). Baseline serum Epo was predictive of response: the lower serum Epo, the higher the likelihood of response (P = 0.002). Thus, epoetin beta administered q.w. is an effective and convenient treatment for anaemia in patients with lymphoproliferative disorders. Tailoring this treatment modality to subjects with defective endogenous Epo production represents a rational use of epoetin from both a medical and a community perspective.

摘要

β-促红细胞生成素,每周三次(t.i.w.),对逆转淋巴增殖性疾病中的贫血有效。本研究调查了皮下注射30,000国际单位β-促红细胞生成素每周一次(q.w.)对于患有淋巴增殖性恶性肿瘤且内源性促红细胞生成素(Epo)产生缺陷的贫血患者是否至少与10,000国际单位每周三次给药同样有效。总体而言,241例患有多发性骨髓瘤、低度非霍奇金淋巴瘤或慢性淋巴细胞白血病的贫血患者,其血清Epo值均≤100 mU/ml,被随机分为接受每周一次(n = 119)或每周三次(n = 122)给药方案,为期16周。主要疗效标准,即第5 - 16周血红蛋白-时间曲线下的时间校正面积,在每周一次和每周三次给药组之间具有可比性[差异 = - 0.20 g/dl(90%置信区间 - 0.52 - 0.11)]。此外,两组的缓解率都很高且相似(每周一次组和每周三次组分别为72%对75%)。基线血清Epo可预测缓解情况:血清Epo越低,缓解的可能性越高(P = 0.002)。因此,每周一次给药的β-促红细胞生成素是治疗淋巴增殖性疾病患者贫血的一种有效且便捷的方法。从医学和社会角度来看,将这种治疗方式应用于内源性Epo产生缺陷的患者代表了促红细胞生成素的合理使用。

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