分析各种因素对淋巴系统恶性肿瘤患者贫血的影响。

Analysis of the influence of various factors on anemia in patients with lymphoid malignancies.

作者信息

Zupanić-Krmek Dubravka, Lang Nada, Jurcić Dragan, Ljubić Nives, Bilić Ante

机构信息

Department of Hematology and Coagulation, Sveti Duh University Hospital, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2011 Dec;50(4):495-500.

PMID:22649879

Abstract

Anemia is a frequent complication of lymphoid neoplasms as a result of the disease and myelotoxic chemotherapy, and has a significant impact on treatment outcome, survival and quality of life. The aim of this study was to investigate clinical characteristics of anemia in lymphoid malignancies and to assess the need of anemia treatment in the context of modern therapeutic possibilities. Fifty-five patients (32 female and 23 male) with non-Hodgkin's lymphoma (NHL, n = 30), chronic lymphocytic leukemia (CLL, n = 8) and multiple myeloma (MM, n = 17) were included in the study. The influence of age, sex, type of malignancy and chemotherapy on the prevalence, severity and type of anemia before and after chemotherapy was analyzed. The prevalence of anemia was 51.02% before (A1) and 55.31% after (A2) chemotherapy. Women had a higher prevalence of anemia than men (63% vs. 43%), but the severity was higher in men at the beginning (103 vs. 99 g/L Hb) and at the end of treatment (101 vs. 89 g/L Hb). The highest prevalence of anemia was found in MM (69%), followed by NHL (44.4%) and CLL (40%) before chemotherapy, and in MM (68.7%), CLL (42.9%) and NHL (20.8%) after chemotherapy. The prevailing anemia was anemia of chronic disease (53.8%), followed by anemia due to multiple causes (anemia of chronic disease + iron deficiency anemia or anemia of chronic disease + hemolytic anemia; 30.7%), anemia due to iron deficiency (11.5%) and hemolytic anemia (7.6%). The prevalence of anemia as a consequence of the disease is high in lymphoproliferative disease, but there was no significant rise under chemotherapy, even showing a decline in NHL patients (44% vs. 21%), however, the severity of anemia increased. Since stage 1 anemia according to the WHO prevailed, only a small number of patients required transfusion therapy. About 27% of all patients had hemoglobin values <100 g/L during chemotherapy and could be candidates for erythropoiesis-stimulating agent treatment.

摘要

贫血是淋巴肿瘤常见的并发症，由疾病本身及骨髓毒性化疗所致，对治疗效果、生存率和生活质量有显著影响。本研究旨在调查淋巴系统恶性肿瘤贫血的临床特征，并在现代治疗条件下评估贫血治疗的必要性。本研究纳入了55例患者（32例女性和23例男性），其中非霍奇金淋巴瘤（NHL，n = 30）、慢性淋巴细胞白血病（CLL，n = 8）和多发性骨髓瘤（MM，n = 17）。分析了年龄、性别、恶性肿瘤类型和化疗对化疗前后贫血患病率、严重程度和类型的影响。化疗前贫血患病率为51.02%（A1），化疗后为55.31%（A2）。女性贫血患病率高于男性（63%对43%），但男性在治疗开始时（血红蛋白103对99 g/L）和治疗结束时（血红蛋白101对89 g/L）贫血严重程度更高。化疗前，贫血患病率最高的是MM（69%），其次是NHL（44.4%）和CLL（40%）；化疗后，依次为MM（68.7%）、CLL（42.9%）和NHL（20.8%）。主要的贫血类型是慢性病贫血（53.8%），其次是多种原因导致的贫血（慢性病贫血+缺铁性贫血或慢性病贫血+溶血性贫血；30.7%）、缺铁性贫血（11.5%）和溶血性贫血（7.6%）。在淋巴增殖性疾病中，由疾病导致的贫血患病率较高，但化疗期间无显著上升，甚至NHL患者有所下降（44%对21%），不过贫血严重程度增加。由于世界卫生组织（WHO）的1期贫血占主导，只有少数患者需要输血治疗。化疗期间，约27%的患者血红蛋白值<100 g/L，可能适合接受促红细胞生成素治疗。