Boccia Ralph, Lillie Tom, Tomita Dianne, Balducci Lodovico
Georgetown University/Center for Cancer and Blood Disorders, Bethesda, Maryland 20817, USA.
Oncologist. 2007 May;12(5):584-93. doi: 10.1634/theoncologist.12-5-584.
Chemotherapy-induced anemia (CIA) may substantially impact the health-related quality of life (HRQoL) of older cancer patients. This exploratory analysis evaluated the effect of darbepoetin alfa administered as a fixed dose (300 microg) every 3 weeks (Q3W) on hematologic outcomes, HRQoL, and safety in older (> or =65 years old) versus younger (<65 years old) patients with CIA (hemoglobin <11 g/dl). Patients were categorized by age at screening: <65, > or =65 to <70, > or =70 to <75, > or =75 to <80, and > or =80 years old. Patients who received at least one dose of darbepoetin alfa were included in the analysis; of 1,493 patients, 724 were > or =65 years old. Age did not appear to influence hematologic outcomes after treatment with darbepoetin alfa; in all age categories, similar percentages of patients (78%-80%) achieved the target hemoglobin in approximately the same time (4-5 weeks). Also, the percentage of patients in each age category who received RBC transfusions was reduced from 10%-13% in month 1 to 2%-4% in month 4. Although younger patients reported the greatest improvement in HRQoL scores, approximately one half in each older age category reported clinically significant improvement in fatigue, and improvement in the Energy and Overall Health Assessment and Work Productivity and Activity Impairment scales. There were no treatment-related deaths. Treatment-related thromboembolic events were reported by <1% of patients <65 years old and <1% of patients > or =65 to <70 and > or =70 to <75 years old. Darbepoetin alfa Q3W appeared well tolerated and effective for treating older patients with CIA.
化疗所致贫血（CIA）可能会严重影响老年癌症患者与健康相关的生活质量（HRQoL）。这项探索性分析评估了每3周（Q3W）给予固定剂量（300微克）的阿法达贝泊汀对年龄较大（≥65岁）和年龄较小（<65岁）的CIA患者（血红蛋白<11 g/dl）血液学指标、HRQoL及安全性的影响。患者按筛查时的年龄分类：<65岁、≥65至<70岁、≥70至<75岁、≥75至<80岁以及≥80岁。接受过至少一剂阿法达贝泊汀的患者纳入分析；1493例患者中，724例年龄≥65岁。接受阿法达贝泊汀治疗后，年龄似乎并未影响血液学指标；在所有年龄组中，相似比例（78%-80%）的患者在大致相同时间（4-5周）达到目标血红蛋白水平。此外，各年龄组接受红细胞输血的患者比例从第1个月的10%-
13%降至第4个月的2%-4%。尽管年轻患者报告HRQoL评分改善最大，但每个老年年龄组约有一半的患者报告疲劳有临床显著改善，且在精力、总体健康评估、工作效率和活动障碍量表方面也有改善。未发生与治疗相关的死亡。<65岁的患者以及≥65至<70岁和≥70至<75岁的患者中，报告治疗相关血栓栓塞事件的比例均<1%。每3周一次的阿法达贝泊汀似乎耐受性良好，对治疗老年CIA患者有效。
