Ludwig H, Fritz E, Leitgeb C, Krainer M, Kührer I, Sagaster P, Umek H
Department of Medicine and Oncology, Wilhelminenspital, Vienna, Austria.
Ann Oncol. 1993 Feb;4(2):161-7. doi: 10.1093/oxfordjournals.annonc.a058423.
Neoplasias, especially in their more advanced stages, are often associated with chronic anemia of malignancy which impairs the patient's physical ability and quality of life.
Forty-two patients with chronic anemia associated with hematological malignancies (18 multiple myelomas, 10 myelodysplastic syndromes) or solid tumors (9 breast cancers, 5 colon cancers) were treated with 150-300 units/kg rHuEPO for a median time period of 16 weeks. Response was defined as an increase of the initial hemoglobin level by at least 2 g/dl.
The response rates for solid tumors were comparable (44.4% and 40% for breast cancer and colon cancer, respectively), whilst the response in patients with hematological malignancies depended strongly on the disease entity (77.8% for multiple myeloma, 10% for myelodysplastic syndrome). Pretreatment serum levels of endogenous erythropoietin (EPO) were significantly higher in non-responding patients than in responders. During rHuEPO therapy, EPO levels in non-responders increased even further, while they remained basically unchanged in responding patients. In responders, the WHO performance status before the start of rHuEPO therapy was more favorable and showed impressive improvement during the course of treatment. The median survival time of responders was 28.0 months as compared to only 9.2 months for non-responders. Clinical symptoms of anemia subsided or at least considerably improved under successful rHuEPO therapy. With the exception of occasional flu-like symptoms, no undesirable effects of rHuEPO treatment were observed.
In conclusion, rHuEPO treatment corrected anemia of malignancy both in patients with hematologic disease and in those with solid tumors, but responsiveness varied considerably amongst the different disease entities.
肿瘤，尤其是在其更晚期阶段，常伴有恶性肿瘤相关性慢性贫血，这会损害患者的身体能力和生活质量。
42例伴有血液系统恶性肿瘤（18例多发性骨髓瘤、10例骨髓增生异常综合征）或实体瘤（9例乳腺癌、5例结肠癌）的慢性贫血患者接受了150 - 300单位/千克的重组人促红细胞生成素（rHuEPO）治疗，中位治疗时间为16周。反应定义为初始血红蛋白水平至少升高2克/分升。
实体瘤的反应率相当（乳腺癌和结肠癌分别为44.4%和40%），而血液系统恶性肿瘤患者的反应在很大程度上取决于疾病类型（多发性骨髓瘤为77.8%，骨髓增生异常综合征为10%）。无反应患者治疗前内源性促红细胞生成素（EPO）血清水平显著高于有反应患者。在rHuEPO治疗期间，无反应患者的EPO水平进一步升高，而有反应患者的EPO水平基本保持不变。在有反应患者中，rHuEPO治疗开始前的世界卫生组织体能状态更好，且在治疗过程中显示出显著改善。有反应患者的中位生存时间为28.0个月，而无反应患者仅为9.2个月。在成功的rHuEPO治疗下，贫血的临床症状减轻或至少有显著改善。除偶尔出现类似流感的症状外，未观察到rHuEPO治疗的不良影响。
总之，rHuEPO治疗纠正了血液系统疾病和实体瘤患者的恶性肿瘤相关性贫血，但不同疾病类型的反应性差异很大。
