Malik I A, Khan Z K, Hakimali A, Sabih M, Rehman G
National Cancer Institute, Clifton, Karachi.
J Pak Med Assoc. 1998 May;48(5):127-31.
Advanced cancer is commonly associated with significant anemia which worsens with the administration of cytotoxic drugs. Erythropoietin (EPO) levels in these patients are usually inappropriately low for the degree of anemia. We evaluated the effect of subcutaneous administration of recombinant human erythropoietin (r-HuEPO) on hematologic parameters and transfusion requirements in anemic cancer patients who were receiving platinum-based chemotherapy. Baseline studies included complete hemogram, reticulocyte count, serum iron, TIBC, ferritin and determination of performance status and quality of life (QOL). Twenty-three patients, 13 females, 10 males with mean age 52 years received 150 units/kg of r-HuEPO three times weekly for a minimum of 10 weeks. They also received supplemental iron. Ovarian cancer was the commonest underlying malignancy. Most of the patients received platinum-based combination chemotherapy. Mean duration of r-HuEPO therapy was 12.6 weeks. Average baseline reticulocyte count was 1.8% which increased to 7.0% after one week therapy. Eight patients had normalization of hemoglobin values. Another eight patients improved their hemoglobin by at least 2 g/dl, however, hemoglobin values remained below the normal range. Two patients had only slight increase in hemoglobin but never required blood transfusion. Three patients who were transfusion dependent had decrease in the transfusion requirements. Two patients had no significant benefit. In most patients response was evident within 2 weeks. All responders had improvement in QOL. No significant toxicity was observed. We conclude that r-HuEPO, given subcutaneously, is highly effective in amelioration of anemia and prevention of or reduction in transfusion requirements in cancer patients receiving platinum-based chemotherapy.
晚期癌症通常伴有严重贫血，且随着细胞毒性药物的使用，贫血会加重。这些患者的促红细胞生成素（EPO）水平通常与贫血程度不相称地低。我们评估了皮下注射重组人促红细胞生成素（r-HuEPO）对接受铂类化疗的贫血癌症患者血液学参数和输血需求的影响。基线研究包括全血细胞计数、网织红细胞计数、血清铁、总铁结合力、铁蛋白以及体能状态和生活质量（QOL）的测定。23例患者，13例女性，10例男性，平均年龄52岁，每周三次接受150单位/千克的r-HuEPO，至少持续10周。他们还接受了铁补充剂。卵巢癌是最常见的潜在恶性肿瘤。大多数患者接受了铂类联合化疗。r-HuEPO治疗的平均持续时间为12.6周。平均基线网织红细胞计数为1.8%，治疗一周后升至7.0%。8例患者血红蛋白值恢复正常。另外8例患者血红蛋白至少提高了2 g/dl，然而，血红蛋白值仍低于正常范围。2例患者血红蛋白仅略有增加，但从未需要输血。3例依赖输血的患者输血需求减少。2例患者未获得显著益处。大多数患者在2周内出现明显反应。所有有反应的患者生活质量均有所改善。未观察到明显毒性。我们得出结论，皮下注射r-HuEPO对改善接受铂类化疗的癌症患者的贫血以及预防或减少输血需求非常有效。
