Anemia,usually due to iron deficiency,is highly prevalent among patients with colorectal cancer.Inflammatory cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron uti...Anemia,usually due to iron deficiency,is highly prevalent among patients with colorectal cancer.Inflammatory cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron utilization.Preoperative anemia predicts for decreased survival.Allogeneic blood transfusion is widely used to correct anemia and is associated with poorer surgical outcomes,increased post-operative nosocomial infections,longer hospital stays,increased rates of cancer recurrence and perioperative venous thromboembolism.Infections are more likely to occur in those with low preoperative serum ferritin level compared to those with normal levels.A multidisciplinary,multimodal,individualized strategy,collectively termed Patient Blood Management,minimizes or eliminates allogeneic blood transfusion.This includes restrictive transfusion policy,thromboprophylaxis and anemia management to improve outcomes.Normalization of preoperative hemoglobin levels is a World Health Organization recommendation.Iron repletion should be routinely ordered when indicated.Oral iron is poorly tolerated with low adherence based on published evidence.Intravenous iron is safe and effective but is frequently avoided due to misinformation and misinterpretation concerning the incidence and clinical nature of minor infusion reactions.Serious adverse events with intravenous iron are extremely rare.Newer formulations allow complete replacement dosing in 15-60 min markedly facilitating care.Erythropoiesis stimulating agents may improve response rates.A multidisciplinary,multimodal,individualized strategy,collectively termed Patient Blood Management used to minimize or eliminate allogeneic blood transfusion is indicated to improve outcomes.展开更多
Methoxy polyethylene glycol epoetin beta which has a long half-life is developed to provide stable control of hemoglobin levels at extended administration intervals compared to darbepoetin alfa. The purpose of this st...Methoxy polyethylene glycol epoetin beta which has a long half-life is developed to provide stable control of hemoglobin levels at extended administration intervals compared to darbepoetin alfa. The purpose of this study was to compare the patterns of use, efficiency of therapy and cost with undergoing hemodialysis patients. Electronic medical record system was used to examine administration frequency, hemoglobin response rate, achievement of target hemoglobin, drug costs. Administration frequency was once in 4 weeks with methoxy polyethylene glycol epoetin beta group and 3 times in 4 weeks with darbepoetin alfa group. Hemoglobin response rate was 61.5% in methoxy polyethylene glycol epoetin beta at the time of 16 weeks. It was not significantly different from 66.7% in darbepoetin alfa （P = 1.000）. The drug cost for methoxy polyethylene glycol epoetin beta group was little higher than darbepoetin alfa group. However, there was no statistically significant difference （P = 0.164）. Use of methoxy polyethylene glycol epoetin beta is as effective and safe as darbepoetin alfa managing renal anemia in hemodialysis patients. Methoxy polyethylene glycol epoetin beta＇s extended administration interval improve patient＇s compliance and enable effective anemia treatment.展开更多
文摘Anemia,usually due to iron deficiency,is highly prevalent among patients with colorectal cancer.Inflammatory cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron utilization.Preoperative anemia predicts for decreased survival.Allogeneic blood transfusion is widely used to correct anemia and is associated with poorer surgical outcomes,increased post-operative nosocomial infections,longer hospital stays,increased rates of cancer recurrence and perioperative venous thromboembolism.Infections are more likely to occur in those with low preoperative serum ferritin level compared to those with normal levels.A multidisciplinary,multimodal,individualized strategy,collectively termed Patient Blood Management,minimizes or eliminates allogeneic blood transfusion.This includes restrictive transfusion policy,thromboprophylaxis and anemia management to improve outcomes.Normalization of preoperative hemoglobin levels is a World Health Organization recommendation.Iron repletion should be routinely ordered when indicated.Oral iron is poorly tolerated with low adherence based on published evidence.Intravenous iron is safe and effective but is frequently avoided due to misinformation and misinterpretation concerning the incidence and clinical nature of minor infusion reactions.Serious adverse events with intravenous iron are extremely rare.Newer formulations allow complete replacement dosing in 15-60 min markedly facilitating care.Erythropoiesis stimulating agents may improve response rates.A multidisciplinary,multimodal,individualized strategy,collectively termed Patient Blood Management used to minimize or eliminate allogeneic blood transfusion is indicated to improve outcomes.
文摘Methoxy polyethylene glycol epoetin beta which has a long half-life is developed to provide stable control of hemoglobin levels at extended administration intervals compared to darbepoetin alfa. The purpose of this study was to compare the patterns of use, efficiency of therapy and cost with undergoing hemodialysis patients. Electronic medical record system was used to examine administration frequency, hemoglobin response rate, achievement of target hemoglobin, drug costs. Administration frequency was once in 4 weeks with methoxy polyethylene glycol epoetin beta group and 3 times in 4 weeks with darbepoetin alfa group. Hemoglobin response rate was 61.5% in methoxy polyethylene glycol epoetin beta at the time of 16 weeks. It was not significantly different from 66.7% in darbepoetin alfa （P = 1.000）. The drug cost for methoxy polyethylene glycol epoetin beta group was little higher than darbepoetin alfa group. However, there was no statistically significant difference （P = 0.164）. Use of methoxy polyethylene glycol epoetin beta is as effective and safe as darbepoetin alfa managing renal anemia in hemodialysis patients. Methoxy polyethylene glycol epoetin beta＇s extended administration interval improve patient＇s compliance and enable effective anemia treatment.
