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聚乙二醇化促红细胞生成素α治疗淋巴增殖性恶性肿瘤贫血患者的疗效和安全性:一项随机、双盲、安慰剂对照研究

Efficacy and safety of darbepoetin alfa in anaemic patients with lymphoproliferative malignancies: a randomized, double-blind, placebo-controlled study.

作者信息

Hedenus Michael, Adriansson Magnus, San Miguel Jesus, Kramer Mark H H, Schipperus Martin R, Juvonen Eeva, Taylor Kerry, Belch Andrew, Altés Albert, Martinelli Giovanni, Watson David, Matcham James, Rossi Gregory, Littlewood Timothy J

机构信息

Department of Internal Medicine, Sundsvall Hospital, Sundsvall, Sweden.

出版信息

Br J Haematol. 2003 Aug;122(3):394-403. doi: 10.1046/j.1365-2141.2003.04448.x.

Abstract

This phase 3, randomized, double-blind, placebo-controlled study was designed to evaluate the efficacy and safety of darbepoetin alfa in anaemic patients with lymphoproliferative malignancies. Patients (n = 344) with lymphoma or myeloma received darbepoetin alfa 2.25 microg/kg or placebo s.c., once weekly for 12 weeks. The percentage of patients achieving a haemoglobin response was significantly higher in the darbepoetin alfa group (60%) than in the placebo group (18%) (P < 0.001), regardless of baseline endogenous erythropoietin level. However, increased responsiveness was observed in patients with lower baseline erythropoietin levels. Darbepoetin alfa also resulted in higher mean changes in haemoglobin than placebo from baseline to the last value during the treatment phase (1.80 g/dl vs 0.19 g/dl) and after 12 weeks of treatment (2.66 g/dl vs 0.69 g/dl). A significantly lower percentage of patients in the darbepoetin alfa group received red blood cell transfusions than in the placebo group (P < 0.001). The efficacy of darbepoetin alfa was consistent for patients with lymphoma or myeloma. Improvements in quality of life were also observed with darbepoetin alfa. The overall safety profile of darbepoetin alfa was consistent with that expected for this patient population. Darbepoetin alfa significantly increased haemoglobin and reduced red blood cell transfusions in patients with lymphoproliferative malignancies receiving chemotherapy.

摘要

这项3期随机双盲安慰剂对照研究旨在评估阿法达贝泊汀对患有淋巴增生性恶性肿瘤的贫血患者的疗效和安全性。344例淋巴瘤或骨髓瘤患者接受皮下注射阿法达贝泊汀2.25微克/千克或安慰剂,每周1次,共12周。无论基线内源性促红细胞生成素水平如何,阿法达贝泊汀组达到血红蛋白反应的患者百分比(60%)显著高于安慰剂组(18%)(P<0.001)。然而,基线促红细胞生成素水平较低的患者反应性增加。从治疗阶段的基线到最后值以及治疗12周后,阿法达贝泊汀组的血红蛋白平均变化也高于安慰剂组(分别为1.80克/分升对0.19克/分升和2.66克/分升对0.69克/分升)。阿法达贝泊汀组接受红细胞输血的患者百分比显著低于安慰剂组(P<0.001)。阿法达贝泊汀对淋巴瘤或骨髓瘤患者的疗效是一致的。使用阿法达贝泊汀还观察到生活质量有所改善。阿法达贝泊汀的总体安全性与该患者群体的预期一致。阿法达贝泊汀显著提高了接受化疗的淋巴增生性恶性肿瘤患者的血红蛋白水平并减少了红细胞输血。

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