Yoshida Y, Anzai N, Kawabata H, Kohsaka Y, Okuma M
Department of Medicine, Faculty of Medicine, Kyoto University, Japan.
Ann Hematol. 1993 Apr;66(4):175-80. doi: 10.1007/BF01703232.
Recombinant human erythropoietin (rhEpo) was administered to 14 patients with myelodysplastic syndrome (MDS) and seven patients with aplastic anemia (AA). In 19 patients, doses of 6000 units were given intravenously three times a week (t.i.w.) with the dose being doubled up to 24,000 units every 8 weeks until a response was obtained. RhEpo was given subcutaneously in two patients. Seven patients, four with MDS and three with AA, showed a significant response with an increase of hemoglobin concentration during therapy. The response occurred at doses of 12,000 units in five and 24,000 units in two patients. Responding patients with both MDS and AA had a relatively low serum Epo (s-Epo) level prior to Epo therapy. MDS responders had either refractory anemia (RA) or RA with ring sideroblasts (RARS), while two of the Epo responders in AA had a severe form of the disease. However, since some of the Epo responders had a high initial s-Epo concentration, a high s-Epo level does not preclude the use of rhEpo. Serial determination of s-Epo levels showed a progressive decline in six of the seven responders even when they were on rhEpo therapy, while the s-Epo levels remained elevated or further increased with time in most nonresponders. RhEpo was well tolerated by all patients. The results suggest that rhEpo is a safe and effective treatment for a certain proportion of patients with MDS and AA. Moreover, serial determination of s-Epo during therapy may be useful in monitoring and predicting the therapeutic effect of rhEpo.
将重组人促红细胞生成素（rhEpo）应用于14例骨髓增生异常综合征（MDS）患者和7例再生障碍性贫血（AA）患者。19例患者静脉注射剂量为6000单位，每周3次（t.i.w.），每8周剂量加倍至24,000单位，直至获得反应。2例患者皮下注射rhEpo。7例患者，4例MDS患者和3例AA患者，在治疗期间血红蛋白浓度升高，显示出显著反应。5例患者在剂量为12,000单位时出现反应，2例患者在剂量为24,000单位时出现反应。MDS和AA的反应性患者在Epo治疗前血清Epo（s-Epo）水平相对较低。MDS反应者为难治性贫血（RA）或伴有环形铁粒幼细胞的RA（RARS），而AA中的2例Epo反应者患有严重形式的疾病。然而，由于一些Epo反应者初始s-Epo浓度较高，高s-Epo水平并不排除使用rhEpo。连续测定s-Epo水平显示，7例反应者中有6例即使在接受rhEpo治疗时也逐渐下降，而大多数无反应者的s-Epo水平随时间保持升高或进一步升高。所有患者对rhEpo耐受性良好。结果表明，rhEpo对一定比例的MDS和AA患者是一种安全有效的治疗方法。此外，治疗期间连续测定s-Epo可能有助于监测和预测rhEpo的治疗效果。
