癌症相关性贫血：千刀万剐式死亡

The anaemia of cancer: death by a thousand cuts.

作者信息

Spivak Jerry L

机构信息

Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21210, USA.

出版信息

Nat Rev Cancer. 2005 Jul;5(7):543-55. doi: 10.1038/nrc1648.

DOI:10.1038/nrc1648

PMID:15965494

Abstract

Cancer has a negative systemic impact on its host in addition to its local or metastatic effects, and no cancer complication is more ubiquitous than anaemia, a condition for which there is now a specific remedy, the recombinant growth factor erythropoietin. This is not a trivial therapeutic consideration, because cancer-associated anaemia has an adverse influence on survival regardless of tumour type. However, the pharmacological correction of anaemia with recombinant erythropoietin could promote tumour growth, whereas the use of tumour-necrosis factor-alpha (TNFalpha) and TNF-related apoptosis-inducing ligand as antitumour agents could exacerbate anaemia, thereby perpetuating tissue hypoxia and tumour progression.

摘要

癌症除了具有局部或转移效应外，还会对其宿主产生负面的全身影响，而没有哪种癌症并发症比贫血更常见，现在有一种针对贫血的特效疗法，即重组生长因子促红细胞生成素。这并非微不足道的治疗考量，因为无论肿瘤类型如何，癌症相关性贫血都会对生存产生不利影响。然而，用重组促红细胞生成素进行贫血的药物纠正可能会促进肿瘤生长，而使用肿瘤坏死因子-α（TNFα）和TNF相关凋亡诱导配体作为抗肿瘤药物可能会加重贫血，从而使组织缺氧和肿瘤进展持续存在。