Stevenson James G, Natale James J
Department of Pharmacy Services, University of Michigan Hospitals and Health Centers, and the College of Pharmacy, University of Michigan, Ann Arbor, Michigan 48109-0008, USA.
Pharmacotherapy. 2007 Mar;27(3):434-46. doi: 10.1592/phco.27.3.434.
Anemia is common in patients with cancer or myelodysplastic syndrome. Erythropoietic therapy offers an effective way to manage anemia by increasing hemoglobin levels, decreasing transfusion requirements, and alleviating symptoms. We reviewed data showing the feasibility and effectiveness of treatment with the erythropoiesis-stimulating protein darbepoetin alfa at extended dosing intervals to treat anemia in patients with cancer receiving multicycle chemotherapy. We also explored the darbepoetin alfa's potential for treating anemia in patients with myelodysplastic syndrome. Data from clinical studies and drug therapy evaluations confirm that darbepoetin alfa administered weekly, every 2 weeks, and every 3 weeks corrects and maintains hemoglobin levels in patients with chemotherapy-induced anemia. In addition, the data demonstrate that both weight-based and fixed dosing with darbepoetin alfa are effective, and that early intervention to treat anemia has clinical benefits. Darbepoetin alfa also is an effective treatment for anemia in patients with cancer not receiving chemotherapy, at extended dosing intervals of at least 3 weeks. Extended dosing for anemia treatment can provide benefits for patients, caregivers, and clinicians because it reduces the number of clinic visits needed and permits synchronizing anemia treatment with chemotherapy cycles. Data from recent studies suggest that darbepoetin alfa is effective for treating anemia in patients with myelodysplastic syndrome; this potential use is being investigated further in ongoing studies. Thus, darbepoetin alfa is an attractive therapy option for patients with chemotherapy or cancer-induced anemia. It allows increased flexibility and simplified dosing and may offer some benefit in the treatment of anemia in patients with myelodysplastic syndrome.
贫血在癌症患者或骨髓增生异常综合征患者中很常见。红细胞生成疗法通过提高血红蛋白水平、减少输血需求和缓解症状，为治疗贫血提供了一种有效方法。我们回顾了相关数据，这些数据显示了促红细胞生成蛋白α-达贝泊汀以延长给药间隔治疗接受多周期化疗的癌症患者贫血的可行性和有效性。我们还探讨了α-达贝泊汀治疗骨髓增生异常综合征患者贫血的潜力。临床研究和药物治疗评估的数据证实，每周、每2周和每3周给药一次的α-达贝泊汀可纠正并维持化疗所致贫血患者的血红蛋白水平。此外，数据表明基于体重的给药和α-达贝泊汀的固定剂量给药均有效，且早期干预治疗贫血具有临床益处。α-达贝泊汀也是未接受化疗的癌症患者贫血的有效治疗方法，给药间隔至少延长至3周。延长贫血治疗的给药间隔可为患者、护理人员和临床医生带来益处，因为它减少了所需的门诊就诊次数，并允许贫血治疗与化疗周期同步。近期研究的数据表明，α-达贝泊汀对治疗骨髓增生异常综合征患者的贫血有效；这一潜在用途正在正在进行的研究中进一步探讨。因此，α-达贝泊汀是化疗或癌症所致贫血患者有吸引力的治疗选择。它增加了灵活性并简化了给药，可能对骨髓增生异常综合征患者的贫血治疗有一定益处。
