Ikenoue Tatsuyoshi, Furumatsu Yoshiyuki, Kitamura Tetsuya
Kyoto University Graduate School of Medicine/Human Health Science, Kyoto, Japan.
Hirano Keijin Clinic, Osaka, Japan.
Oxf Med Case Reports. 2021 May 24;2021(5):omab026. doi: 10.1093/omcr/omab026. eCollection 2021 May.
Treatment of anaemia and reduction of transfusion are major therapeutic goals in patients with low-risk myelodysplastic syndrome (MDS). Although erythropoiesis-stimulating agents (ESAs) are widely used to reduce transfusion requirement, ESAs lose effectiveness within 12 months. We report a 65-year-old Japanese woman diagnosed with low-risk MDS who underwent long-term use of continuous epoetin β pegol, an erythropoietin receptor activator (CERA), and her treatment after CERA failure. She received darbepoetin alpha (DPO) for transfusion-dependent anaemia and was free from transfusion. However, after 8 months, DPO lost effectiveness. She then received CERA and recovered from anaemia. Her haemoglobin level remained >10 g/dl for 3 years and 4 months. However, even CERA lost effectiveness, and she received roxadustat treatment with CERA, leading to recovery from anaemia again. Although further evidence is required, the extension of the no-transfusion period provided by ESAs and roxadustat is important and is awaited among low-risk MDS patients.
治疗贫血和减少输血是低危骨髓增生异常综合征（MDS）患者的主要治疗目标。尽管促红细胞生成素（ESAs）被广泛用于减少输血需求，但ESAs在12个月内会失去疗效。我们报告了一名65岁的日本女性，她被诊断为低危MDS，长期使用持续促红细胞生成素β聚乙二醇（一种促红细胞生成素受体激活剂，CERA），以及CERA失效后的治疗情况。她因输血依赖型贫血接受了达贝泊汀α（DPO）治疗，且不再需要输血。然而，8个月后，DPO失去了疗效。然后她接受了CERA治疗并从贫血中恢复。她的血红蛋白水平在3年4个月的时间里一直保持>10 g/dl。然而，即使是CERA也失去了疗效，她在接受CERA治疗的同时接受了罗沙司他治疗，再次从贫血中恢复。尽管还需要进一步的证据，但ESAs和罗沙司他延长无输血期很重要，低危MDS患者对此翘首以盼。
