重组人促红细胞生成素-α治疗癌性贫血的疗效和安全性

Efficacy and safety of recombinant human erythropoietin-alpha(rHuEPO) in the treatment of cancer anemia

目的研究重组人促红细胞生成素(rHuEPO)治疗癌性贫血的疗效和安全性。方法已获得明确病理诊断的癌症患者,伴有非髓性贫血,化疗前外周血红蛋白(hb)<110 g/L,应用rHuEPO 40 000 U每周皮下注射1次,疗程6周,同时至少化疗2周期。比较治疗前后患者Hb和红细胞压积(Hct)的水平。评价一般状况评分的变化以及相关药物不良反应,应用癌症治疗性贫血功能评价(FACT-An)量表对贫血患者进行治疗前后的生活质量测评。结果入组患者给予rHuEPO后Hb水平呈持续上升趋势,在治疗后第2周及第4周Hb比基础值(79.56 g/L)上升≥20 g/L的患者分别占26.9%和61.3%;第2周(n=67)及第4周(n=62)Hb的平均值与治疗前相比差异均具有显著性(P<0.01);第2周及第4周Hct的平均值与治疗前相比也有所提高,改善患者生存质量,所有患者均耐受良好。结论在恶性肿瘤贫血患者中使用rHuEPO,可有效快速提高患者的血红蛋白水平,改善患者的贫血状况,该疗法耐受性较好,值得进一步扩大临床研究。

Objective To study the efficacy and safety of recombinant human erythropoi- etin？ alpha （rHuEPO）in the treatment of cancer anemia. Methods Patients with confirmed ma- lignant cancer- related anemia were enrolled in the study. Before chemotherapy, peripheral hemoglobin （hb）, less than 110 g/L, was subcutaneously injected with rHuEPO 40 000 U once ev- ery week. The treatment lasted for six weeks. At the same time, patients received chemotherapy for at least 2 cycles. The levels of Hb and hematocrit （Hct） were compared after treatment. The changes of normal conditions and adverse events were assessed. The assessment of the quality of life before and after treatment was conducted by using anemia function evaluation （FACT-An） scale. Results After administering rHuEPO, the Hb levels continued to rise in the enrolled patients. At the 2nd and 4th weeks, patients whose Hb value was higher than baseline values （79.56 g/L） and the rate of increase was greater than or equal to 20 g/L, accounted for 26.9 % and 61.3 %, respec- tively. At the 2nd and 4th weeks, the average of Hct increased. Patients＇ quality of life improved, and all the patients were well tolerated. Conclusion Induction therapy followed by maintenance with rHuEPO can improve the level of hemoglobin significantly and quickly in anemic cancer pa- tients.