Service d'Hématologie, Hôpital Avicenne - Université Paris 13, 125, rue de Stalingrad 93000 Bobigny, France.
Expert Opin Biol Ther. 2010 Apr;10(4):605-14. doi: 10.1517/14712591003709713.
Anemia is the leading clinical manifestation in myelodysplastic syndromes (MDS), significantly altering quality of life. Darbepoetin alfa has recently been added to the armentarium of erythropoiesis stimulating agents (ESAs) for the treatment of anemia in MDS.
We review here the efficacy and safety data on the use of darbepoetin alfa in the management of anemia in MDS patients. Published reports covering the period from 2005 till today were reviewed, as well as updated guidelines on the use of ESAs.
Darbepoetin alfa administered, during correction phase, once a week or at longer intervals, yielded erythroid response rates comparing favourably with those obtained with recombinant human erythropoietin (rHuEPO) in lower-risk MDS. During maintenance phase, intervals between injections can be further increased in many responders. Quality of life was consistently improved in responders and the drug was overall well tolerated.
Those results, together with recent studies showing improved long-term outcomes in responders, support the use of darbepoetin, among other ESAs, for the treatment of anemia of lower-risk MDS, as recommended by international guidelines.
贫血是骨髓增生异常综合征（MDS）的主要临床表现，显著改变生活质量。达贝泊汀α最近已被添加到红细胞生成刺激剂（ESA）的武器库中，用于治疗 MDS 贫血。
我们在此回顾了达贝泊汀α在 MDS 患者贫血管理中的疗效和安全性数据。回顾了涵盖 2005 年至今的已发表报告，以及关于 ESA 使用的最新指南。
在纠正阶段，每周或更长时间一次给予达贝泊汀α，其红细胞反应率与低危 MDS 中重组人促红细胞生成素（rHuEPO）获得的反应率相当。在维持阶段，许多应答者的注射间隔可以进一步延长。应答者的生活质量得到持续改善，药物总体上耐受良好。
这些结果，加上最近的研究表明应答者的长期预后得到改善，支持使用达贝泊汀和其他 ESA 治疗低危 MDS 的贫血，正如国际指南所推荐的。
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