Анемия при химиотерапии злокачественных опухолей: эффективность Эпрекса (эпоэтин альфа)


В.В. Бредер, Н.С. Бесова, В.А. Горбунова

Анемия при химиотерапии злокачественных опухолей: эффективность Эпрекса (эпоэтин альфа).
В статье проведен анализ литературных данных о значении анемии для качества жизни и эффективности лечения онкологических больных. Представлен опыт собственного применения рекомбинантного человеческого эритропоэтина альфа (Эпрекс) при анемии, сопровождающей злокачественный процесс. Продемонстрирована высокая эффективность и безопасность терапии Эпрексом у этой категории больных. Даны рекомендации по оптимальным схемам дозирования препарата в зависимости от уровня гемоглобина крови. Отмечено выраженное позитивное влияние Эпрекса на параметры качества жизни пациентов - уменьшение слабости, повышение работоспособности. Своевременная коррекция пониженного уровня гемоглобина крови позволяет повысить эффективность и переносимость основного противоопухолевого лечения.

Литература






  1. Nowrousian MR, et al. Pathophysiology of cancer-related anemia, in Smythe J, et al (eds): rh-erythropoietin in Cancer Supportive Treatment. New York, NY, Marcel Dekker 1996, p. 13–34.
  2. Means RT Jr. Pathogenesis of the anemia of chronic disease: a cytokine-mediated anemia. Stem Cells 1995;13:32–37.
  3. Salvarini C, Casali B, Salvo D, et al. The role of interleukine-1, erythropoietin and red cell bound immunoglobulins in the anemia of rheumatoid arthritis. Clin Exp Rheumatol 2000;9:2414–6.
  4. Groopman JE, Itri LM. Chemotherapy-induced anemia in adults: Incidence and treatment. J Natl Cancer Inst 1999;91:1616–34.
  5. Canaparo R, Casale F, Muntoni E, et al. Plasma erythropoietin concentrations in patients receiving intensive platinum or nonplatinum chemotherapy. Br J Clin Pharmacol 2000;50:146–53.
  6. Pivot X, Guardiola E, Etienne M, et al. An analysis of potential factors allowing an individual prediction of cisplatin-induced anaemia. Eur J Cancer 2000;36:852–57.
  7. Wood PA, Hrushesky WJ. Cisplatin-associated anemia: An erythropoietin deficiency syndrome. J Clin Invest 1995;95:1650–59.
  8. Coiffiet В. Anemia associated with non-platinum chemotherapy (CT) for Hodgkin's lymphoma (HL) or non-Hodgkin's lymphoma (NHL). Eur J Cancer 1999;35(suppl. 4):S331 (abstr).
  9. Ludwig H, Birgegard G, Barrett-Lee, et al. Prevalence and management of anemia in patients with hematologic malignancies and solid tumors: results from the European Cancer Anemia Survey (ECAS), Blood 2002, abstr 884.
  10. Skillings JR, et al. An epidemiological review of red cell transfusions in cancer chemotherapy. Cancer Prev Control 1999;3:207–12.
  11. Ray-Coquart I, Le Cesne A, Rubo MT, et al. Risk model for severe anemia requiring red blood cell transfusion after cytotoxic conventional chemotherapy regimens. The Elypse I Study Group. J Clin Oncol 1999;17:2840–46.
  12. Barrett-Lee PJ, Bailey NP, O'Brien MER, et al. Large-scale UK audit of blood transfusion requirements and anemia in patients receiving cytotoxic chemotherapy. Br J Cancer 2000;82:93–97.
  13. Coiffiet В. Anemia associated with non-platinum chemotherapy (CT) for Hodgkin's lymphoma (HL) or non-Hodgkin's lymphoma (NHL). Eur J Cancer 1999;35(suppl. 4):S331(abstr).
  14. Bland LB, Tangen CM, Thompson IM, et al. Prognostic value of anemia in untreated metastatic prostate cancer: A multivariate analysis of SWOG 8894. ASCO 2004, аbstr 4574.
  15. Anand IS, Chandrashckhar Y, Perrari R. Pathogenesis of edema in chronic anemia: studies of body water, sodium, renal function, haemodynamics and plasma hormones. Br Heart J 1993;70:357–62.
  16. Portenoy RK, Miaskowski C. Assessment and management of cancer-related fatigue, in Berger A, Portenoy RK, Weissman DE (eds): Principles and Practice of Supportive Oncology. Philadelphia, PA, Lippincott-Raven 1998, p. 109–18.
  17. Ashbury FD, Findlay H, Reynolds B, et al. A Canadian survey of cancer patients' experiences: Are their needs being met? J Pain Symptom Manage 1998;16:298–306.
  18. Stone P, Richards M, Hardy J. Fatigue in patients with cancer. Eur J Cancer 1998;34:1670–76.
  19. Simon AM, Zittoun R. Fatigue in cancer patients. Curr Opin Oncol 1999;11:244–49.
  20. Vogelzang NJ, Breitbart W, Cella D, et al. Patient, care-giver, and oncologist perceptions of cancer-related fatigue: Results of a tripart assessment survey. The Fatigue Coalition. Semin Hematol 1997;34(suppl. 2):4–12.
  21. Carelle N, Piotto, Bellanger A, et al. Changing patient perception of the side effects of cancer chemotherapy. Cancer 2002;95:155–63.
  22. Cella D. The Functional Assessment of Cancer Therapy – Anemia (FACT-An) Scale: A new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol 1997;34(suppl. 2):13–19.
  23. Demetri GD, Kris M, Wade J, et al, for the Procrit Study Group: Quality-of-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: Results from a prospective community oncology study. J Clin Oncol 1998;16:3412–25.
  24. Gangrand LF. The history of blood transfusion. Br J Haematol 2000;110:758–67.
  25. Stanworth SJ, Cockburn HAC, Boralessa H, et al. Which groups of patients are transfused? Vox Sanguins 2002:83:352–27.
  26. Krantz SB. Blood 1991;77:419–34.
  27. Glaspy J, Bukowski R, Steinberg D, et al. Impact of therapy with epoetin alpha on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. J Clin Oncol 1997;15:1218–34.
  28. Gorbounova V, Breder V, Besova N. Eprex in the treatment of Cisplatin-induced anemia in cancer patient., 11th International Congress on Anti-Cancer Treatment; p. 274. February 6–9, 2001 Abstr. AB35. Paris
  29. Crawford J. Anemia and lung cancer. Lung Сancer 2002:38:S75–78.
  30. Gabrilove JL, Cleeland CS, Livingston RB, et al. Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: improvements in hemoglobin and quality of life are similar to three-times-weekly dosing. J Clin Oncol 2001;19:2875–82.
  31. Crawford J, Cella D, Cleeland CS, et al. Relationship between changes in haemoglobin level and quality of life during chemotherapy in anaemic cancer patients receiving epoetin alpha therapy. Cancer 2002;95:888–95.
  32. Stricker CT, Matthews G, Stein S. Anemia and fatigue during adjuvant chemotherapy for breast cancer: Patterns and impact on quality of life. ASCO 2004, abstr 8060.
  33. Savonije J, Van Groeningen C, Van Bochove A. Early intervention with epoetin-alfa during platinum-based chemotherapy. ASCO 2004, abstr 8111.
  34. Pronzato P, Cortesi E, Van der Rijt C, et al. Early intervention with epoetin alfa in breast cancer (BC) patients (pts) undergoing chemotherapy (CT): Results of a randomized, multicenter, phase IIIb study (epo-int-47 Study Group) Ann of Oncol 13(suppl. 5):168, abstr. 620.
  35. Shasha D, George MJ, Harrison LB. Once-weekly dosing of epoetin alfa increases hemoglobin and improves quality of life in anemic cancer patients receiving radiation therapy either concomitantly or sequentially with chemotherapy. Blood 2000;96:434a, abstr 1866.
  36. Glaser С, Millesi F, Wanschitz B, et al. Erythropoietin treatment increases efficacy of neoad'uvant radiochemotherapy and improves cancer free survival of patients with oral squamous cell carcinoma; A 17 month follow up. Proc ASCO 1999;18:399a, abstr.
  37. Littlewood TJ, Bajetta E, Nortier WR, et al. Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: Results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 2001;19:2865–74.
  38. Tampellini M, Saini A, Alabiso I, et al. The role of hemoglobin level in predicting the response to first-line chemotherapy in advanced colorectal cancer (ACC) patients. ASCO 2004, abstr. 3564.



Бионика Медиа