Adamson John W
Division of Hematology/Oncology, University of California, San Diego, CA 92161, USA.
Hematology Am Soc Hematol Educ Program. 2008:159-65. doi: 10.1182/asheducation-2008.1.159.
Anemia is a common complication in patients with inflammatory diseases of many kinds, including cancer. The mechanisms that have captured the most attention include cytokine-mediated changes in both the production of and the response to erythropoietin (Epo), as well as important alterations in iron metabolism. The last is brought about by the relatively recently recognized peptide hormone, hepcidin. The availability of recombinant human Epo and its derivatives (known by class as Erythropoietic Stimulating Agents, ESAs) has dramatically changed anemia management in patients with cancer but, in the process, has raised as many issues as have been answered. This chapter reviews the mechanisms resulting in anemia in inflammation, including cancer, and focuses on the controversies around management with the ESAs and the adjuvant use of iron in anemia management.
贫血是包括癌症在内的多种炎症性疾病患者的常见并发症。最受关注的机制包括细胞因子介导的促红细胞生成素（Epo）生成及反应变化，以及铁代谢的重要改变。后者是由相对较新发现的肽类激素铁调素引起的。重组人促红细胞生成素及其衍生物（统称为促红细胞生成刺激剂，ESAs）的出现极大地改变了癌症患者贫血的治疗方式，但在此过程中，引发的问题与已解决的问题一样多。本章回顾了包括癌症在内的炎症性疾病导致贫血的机制，并重点讨论了促红细胞生成刺激剂治疗的争议以及铁剂在贫血治疗中的辅助应用。
