Cazzola M
Internal Medicine and Medical Oncology, IRCCS Policlinico S. Matteo, Pavia, Italy.
Curr Opin Hematol. 1998 Mar;5(2):103-8. doi: 10.1097/00062752-199803000-00004.
Recombinant human erythropoietin is used in clinical practice mainly for treatment of anemia of renal failure. In the past years, however, its use has been approved for other indications, including prevention of anemia in surgical patients or in patients undergoing platinum-based chemotherapy, treatment of anemia of prematurity, of anemia induced by zidovudine therapy in HIV-infected patients, and of anemia induced by chemotherapy of nonmyeloid malignancies. Erythropoietin should routinely be given subcutaneously to maximize its effects. Most patients undergoing rHuEpo treatment develop functional iron deficiency, a situation in which iron supply to the erythroid marrow is inadequate for the erythrocyte precursor demand. Iron supplementation should, therefore, be given to all individuals receiving rHuEpo except for those patients with increased serum iron and transferrin saturation. Outside the setting of uremia, only a portion of patients can clearly benefit from erythropoietin therapy; therefore, the use of rHuEpo should be individualized in nonrenal applications.
重组人促红细胞生成素在临床实践中主要用于治疗肾衰竭贫血。然而，在过去几年中，其应用已被批准用于其他适应症，包括预防外科手术患者或接受铂类化疗患者的贫血、治疗早产儿贫血、治疗人类免疫缺陷病毒（HIV）感染患者齐多夫定治疗引起的贫血以及非髓系恶性肿瘤化疗引起的贫血。促红细胞生成素通常应皮下注射以最大化其效果。大多数接受重组人促红细胞生成素（rHuEpo）治疗的患者会出现功能性缺铁，即红细胞生成骨髓的铁供应不足以满足红细胞前体的需求。因此，除血清铁和转铁蛋白饱和度升高的患者外，所有接受rHuEpo治疗的个体都应补充铁剂。在尿毒症情况之外，只有一部分患者能明显从促红细胞生成素治疗中获益；因此，在非肾脏应用中，rHuEpo的使用应个体化。
