Takagi M, Miyamoto Y, Kosaka M, Saito S
First Department of Internal Medicine, School of Medicine, University of Tokushima.
Rinsho Ketsueki. 1992 Sep;33(9):1151-7.
Serum erythropoietin (Epo) levels were measured in 53 patients with multiple myeloma (MM), 49 normal subjects and 53 patients with some hematological diseases including aplastic anemia (AA), iron deficiency anemia, etc. to study the significance of erythropoietin in anemia of MM. The serum Epo level was 72.0 +/- 94.4 mIU/ml (mean +/- SD) in MM patients, which was significantly higher than in normal subjects (24.1 +/- 6.1 mIU/ml), but lower than in AA patients (7069.9 +/- 9406 mIU/ml). A significant inverse correlation was found between the hemoglobin (Hb) levels and the logarithmic values of serum Epo levels (r = -0.543, p < 0.05) in MM patients. This inverse correlation was stronger (r = -0.636, p < 0.05) in MM patients without renal dysfunction than in whole MM patients, while no correlation was observed in MM patients with renal dysfunction. These results indicate that MM patients with renal dysfunction have a low ability to synthesize Epo and that the supplemental therapy of recombinant Epo is effective to improve their anemia. In addition, the circadian rhythm of serum Epo level was lower in the morning than in the afternoon in both MM patients and normal controls. Serum Epo levels after chemotherapy in MM patients were elevated temporarily and then decreased in spite of no change of blood Hb level.
对53例多发性骨髓瘤（MM）患者、49名正常受试者以及53例包括再生障碍性贫血（AA）、缺铁性贫血等在内的血液系统疾病患者测定血清促红细胞生成素（Epo）水平，以研究Epo在MM贫血中的意义。MM患者血清Epo水平为72.0±94.4 mIU/ml（均值±标准差），显著高于正常受试者（24.1±6.1 mIU/ml），但低于AA患者（7069.9±9406 mIU/ml）。MM患者血红蛋白（Hb）水平与血清Epo水平对数值之间存在显著负相关（r = -0.543，p < 0.05）。在无肾功能不全的MM患者中，这种负相关更强（r = -0.636，p < 0.05），而在有肾功能不全的MM患者中未观察到相关性。这些结果表明，有肾功能不全的MM患者合成Epo的能力较低，补充重组Epo治疗对改善其贫血有效。此外，MM患者和正常对照者血清Epo水平的昼夜节律均为上午低于下午。MM患者化疗后血清Epo水平暂时升高，随后下降，尽管血液Hb水平无变化。
