Katodritou Eirini, Terpos Evangelos, Zervas Konstantinos, Speletas Matthaios, Kapetanos Dimitrios, Kartsios Charalambos, Verrou Evgenia, Banti Anastasia, Effraimidou Smaragda, Christakis John
Department of Hematology, Theageneion Cancer Center, Thessaloniki, Greece.
Ann Hematol. 2007 May;86(5):369-76. doi: 10.1007/s00277-007-0258-x. Epub 2007 Feb 14.
The aim of the study was to evaluate the role of hypochromic erythrocytes (HYPO%) compared to "traditional" and novel markers of iron status and erythropoiesis in recognizing iron-restricted erythropoiesis (IRE) and predicting response to erythropoietin (rHuEPO) in anemic patients with myeloma and lymphoma. Forty-one newly diagnosed patients who received epoetin-beta at a subcutaneous weekly dose of 30,000 IU for 6 weeks were studied. Response to rHuEPO was observed in 27 patients (65.8%). Twelve non-responders received, additionally, 200 mg of IV iron sucrose, weekly, for 4 weeks. Evaluation of markers was performed at baseline and on weeks 1, 2 and 6 for all patients and also on weeks 7-10 for non-responders to rHuEPO. Baseline HYPO%, at a cut-off value of <5%, and an increment in reticulocyte absolute number (RETICS-AB) >or= 50,000/microl and reticulocyte hematocrit (RETICS-Hct) >or= 50%, between baseline and week 2, were independent predictive factors for response to rHuEPO. We found that these markers had superior predictive value for response to rHuEPO than four widely used predictive models. Furthermore, a baseline HYPO% count of above 5% proved superior over serum ferritin < 100 ng/ml and transferrin saturation < 20% in recognizing IRE. In conclusion, baseline HYPO% either alone or in combination with RETICS-AB or RETICS-Hct after 2 weeks of rHuEPO treatment could be reliably used in predicting response to rHuEPO. Additionally, HYPO% has proved a reliable marker for recognizing IRE before rHuEPO treatment and, thus, could be used for identifying patients who will benefit from IV iron supplementation.
本研究的目的是评估低色素红细胞（HYPO%）相较于铁状态和红细胞生成的“传统”及新型标志物，在识别骨髓瘤和淋巴瘤贫血患者的铁限制红细胞生成（IRE）以及预测对促红细胞生成素（rHuEPO）反应方面的作用。研究了41例新诊断患者，他们接受皮下每周一次剂量为30,000 IU的促红细胞生成素β，共6周。27例患者（65.8%）观察到对rHuEPO有反应。12例无反应者另外接受每周200 mg静脉注射蔗糖铁，共4周。对所有患者在基线、第1、2和6周进行标志物评估，对rHuEPO无反应者在第7 - 10周也进行评估。基线HYPO%，临界值<5%，以及基线至第2周网织红细胞绝对数（RETICS - AB）增加≥50,000/μl和网织红细胞压积（RETICS - Hct）≥50%，是对rHuEPO反应的独立预测因素。我们发现这些标志物对rHuEPO反应的预测价值优于四种广泛使用的预测模型。此外，在识别IRE方面，基线HYPO%计数高于5%被证明优于血清铁蛋白<100 ng/ml和转铁蛋白饱和度<20%。总之，基线HYPO%单独或与rHuEPO治疗2周后的RETICS - AB或RETICS - Hct联合使用，可可靠地用于预测对rHuEPO的反应。此外，HYPO%已被证明是rHuEPO治疗前识别IRE的可靠标志物，因此可用于识别将从静脉补铁中获益的患者。
