Lehoczky Ottó, Pulay Tamás
Országos Onkológiai Intézet Nogyógyászati Osztálya, Budapest.
Orv Hetil. 2007 Nov 11;148(45):2133-7. doi: 10.1556/OH.2007.28188.
The European Organisation for Research and Treatment of Cancer distributed the modified guidelines for blood transfusions and erythropoietic drugs in the treatment of cancer anemia in the year 2006. According to this document the blood transfusions are indicated at the level of 9 g/dL of hemoglobin. Up to this year a definitive limit for applying blood transfusion in chemotherapy-induced anemia has not been determined in Hungary.
The authors evaluated their practice in the treatment of anemia with blood transfusions in ovarian cancer patients treated in 2005. In lack of international or domestic guidelines, considering also the clinical status of the patients, the authors applied blood transfusions at a hemoglobin level of 10 g/dL.
190 epithelial ovarian cancer patients were given chemotherapy in the Gynecological Department at the National Institute of Oncology, Hungary. Selected for the patient packed red blood cell transfusion was administered if the hemoglobin has fallen below 10 g/dL, and together with it most patients (51/64 = 79,6%) were given erythropoietic drugs as well.
Blood transfusion was given in 64 of 190 (34%) chemotherapies patients and almost the half of these latter patients (34/64 = 53%) were transfused more than once. In 86% of patients blood transfusion was given for G2 anemia. The largest rate (16/16) of blood transfusions according to the different types of chemotherapy was done in patients receiving combined therapy with gemcitabine and carboplatin.
Chemotherapy for ovarian cancer causes severe anemia (hemoglobin level < 10 g/dL) in one third of patients. Besides blood transfusions, physicians have to pay attention to the necessity of erythropoietic drugs, as well.
欧洲癌症研究与治疗组织于2006年发布了关于癌症贫血治疗中输血及促红细胞生成药物的修订指南。根据该文件,血红蛋白水平降至9 g/dL时需进行输血。直至今年,匈牙利仍未确定化疗所致贫血患者输血的明确界限。
作者评估了2005年治疗的卵巢癌患者中输血治疗贫血的实践情况。由于缺乏国际或国内指南,同时考虑到患者的临床状况,作者在血红蛋白水平为10 g/dL时进行输血。
匈牙利国立肿瘤研究所妇科对190例上皮性卵巢癌患者进行了化疗。若血红蛋白降至10 g/dL以下,则为患者输注浓缩红细胞,并且大多数患者(51/64 = 79.6%)同时接受了促红细胞生成药物治疗。
190例接受化疗的患者中有64例(34%)接受了输血,其中近一半患者(34/64 = 53%)接受了不止一次输血。86%的患者因G2级贫血接受输血。在接受吉西他滨与卡铂联合治疗的患者中,根据不同化疗类型进行输血的比例最高(16/16)。
卵巢癌化疗导致三分之一的患者出现严重贫血(血红蛋白水平<10 g/dL)。除输血外,医生还必须关注促红细胞生成药物的必要性。