红细胞生成素治疗恶性肿瘤贫血

用重组人红细胞生成素治疗１２例恶性肿瘤贫血患者，结果治疗组Ｈｂ显著上升，对照组Ｈｂ化疗后亦有上升，但远不如治疗组显著（Ｐ〈０．０１），５例依赖输血患者输血量显著减少，对照组仅略减少（Ｐ〈０．０５），治疗期间未发现明显副作用，结果表明ｒｈＥｐｏ是治疗恶性肿瘤贫血的有效药物。     

重组人红细胞生成素治疗难治性贫血

重组人红细胞生成素治疗难治性贫血吴兴中，王学文，刘海宁，钱晓萍国外近年来应用基因重组人红细胞生成素（ｒＨｕＥＰＯ）治疗难治性贫血已显示一定的疗效，这些难治性贫血包括骨髓增生异常综合征（ＭＤＳ）－难治性贫血（ＭＤＳ－ＲＡ），再生障碍性贫血（再障），骨髓...     

多发性骨髓瘤贫血的发病机制和治疗进展

多发性骨髓瘤 (MM)是一种骨髓浆细胞系异常增生引起的血液系统恶性肿瘤 ,其发生率约占血液系统恶性肿瘤的10 % ,其典型的临床表现有骨痛、贫血、肾功能损害和感染等[1] 。贫血的发生率在初诊患者达 70 % ,随着疾病的进展 ,几乎所有患者最终均出现贫血。和慢性病性贫血 (ACD)一样 ,MM所致贫血通常也是正细胞正色素性贫血 ,其主要原因为大量的骨髓腔被骨髓瘤细胞侵占红系生成受抑、肾功能受损、化疗引起的骨髓抑制及伴发的自身免疫性溶血、出血等 ,目前认为白细胞介素 6 (IL 6 )、IL 1、肿瘤坏死因子(TNF)等细胞因子产生过多引起的红细…     

重组人类红细胞生成素干预婴幼儿缺铁性贫血的疗效观察

婴幼儿缺铁性贫血是小儿常见的疾病 ,传统的治疗方法是增加铁的摄入和 (或 )补充铁剂。但临床实践中常因为铁剂所致的胃肠道反应及小儿辅食添加困难而使贫血纠正不理想。近年来有些学者用重组人类红细胞生成素 (recombinanthumanery thropoietin ,rh Epo)治疗或预防早产儿及其他类型的贫血 ,取得了较满意的疗效〔1 ,2〕。本文应用rh Epo治疗 1 5例婴幼儿缺铁性贫血患者 ,取得了明显疗效 ,现报告如下。1　资料与方法1 .1 　 一般资料本组病例均来自我院 2 0 0 1年 1月～ 2 0 0 1年 1 0月住院或门诊患儿共 35例 ,其中有 3例 (观察组 2例 ,对…     

红细胞参数在多发性骨髓瘤筛查中的临床价值

目的:通过比较多发性骨髓瘤(MM)患者与健康体检人群红细胞参数的差异,探讨红细胞参数在MM患者筛查中的临床价值。方法:回顾性分析广州市番禺区中心医院2012年1月至2022年1月,初诊为MM患者109例(病例组)以及同期健康体检者110例(对照组)的红细胞参数。比较2组间血红蛋白(Hb)、平均红细胞体积(MCV)、红细胞体积分布宽度(RDW)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)的均值及阳性率的差异。进一步从病例组中筛选出贫血患者89例(MM贫血组)及对照组中筛选出非贫血者109例(对照非贫血组),比较2组间红细胞相关参数的均值及阳性率差异,精准分析MM贫血患者的特点;并对差异有统计学意义的项目进一步进行受试者工作特征(ROC)曲线分析,探讨红细胞相关参数在MM中的诊断价值。结果:病例组和对照组比较,均值水平MCV、MCH差异无统计学意义(P>0.01),Hb、MCHC、RDW差异有统计学意义(P<0.01);阳性率红细胞参数差异有统计学意义(P<0.01),尤以Hb(81.7%)、RDW(75.2%)阳性率较高。MM贫血组和对照非贫血...     

类风湿关节炎贫血患者血清促红细胞生成素的观察

类风湿关节炎贫血患者血清促红细胞生成素的观察张育，张之南，于孟学，蒋明，杨江燕据报道，１６％～６５％的类风湿关节炎（ＲＡ）患者伴有轻度至中度贫血，但其机制尚未明了，我们对３７例ＲＡ患者血清促红细胞生成素（ＥＰＯ）水平进行了观察，并探讨ＥＰＯ水平的改变...     

左旋肉碱与促红细胞生成素并用治疗尿毒症贫血

目的：观察左旋肉膜对重组人红细胞生成素（ｒ－ＨｕＥＰＯ）疗效的影响。方法：将４０例尿毒症血透患者随机分成两组。两组同时于血透后予以ｒ－ＨｕＥＰＯ１００￣１５０Ｕ／（ｋｇ．周）皮下注射。待血球压积（Ｈｃｔ）≥３０％后减量,维持Ｈｃｔ在３０％￣３５％。治疗组于每次血透后静脉推注左旋肉碱１．０ｇ,而对照组不用。血浆游离肉碱浓度采用放射化学酶联法测定。结果：治疗组血浆游离肉碱浓度及血红蛋白（Ｈｂ）、Ｈｃｔ     

促红细胞生成素治疗食管癌患者化疗相关贫血疗效观察

食管癌患者65例,随机分为治疗组和对照组,治疗组在化疗的基础上给予重组人促红细胞生成素(rhEPO)40 000 U/周皮下注射.分别于化疗后4、8周评估两组血红蛋白(Hb)、红细胞压积(HCT)水平,输血需求量和不良反应情况.结果 发现,与同组治疗前及对照组治疗后比较,给予rhEPO治疗8周后,治疗组Hb、HCT水平明显上升,输血需求量较少,不良反应率低.认为rhEPO能够改善食管癌化疗患者的贫血症状,安全有效.     

Effective treatment of the anaemia associated with multiple myeloma by recombinant human erythropoietin

We administered recombinant human erythropoietin to an anaemic patient with multiple myeloma (IgD, λ type) who had been dependent on blood transfusions. The recombinant human erythropoietin (60 units/kg) was given intravenously three times weekly and transfusion requirements, haemoglobin level, and reticulocyte responses were monitored. The patient had an increase in haemoglobin level and reticulocyte counts within 14 days, and no longer needed transfusions. No organ dysfunction or other toxic effects were observed. We consider that recombinant human erythropoietin may be a new method to treat anaemia associated with multiple myeloma.     

重组人促红细胞生成素治疗结肠和直肠癌化疗相关贫血

目的 :观察重组人促红细胞生成素 (rhEPO)治疗结、直肠癌化疗相关贫血的疗效。方法 :选择 6 2例结、直肠癌采用以奥沙利铂为主联合方案化疗所致贫血患者 ,随机分为两组 :rhEPO治疗组 34例 ,给予皮下注射rhEPO 4 0 0 0 0U/周。对照组 2 8例 ,不给予rhEPO治疗 ,仅给予五参芪口服液。结果 :治疗后 4周起治疗组患者血红蛋白 (Hb) ,红细胞压积 (HCT)、红细胞总数 (RBC)均明显上升 ,与对照组相比差异有统计学意义 (P <0 .0 1)。rhEPO治疗组总有效率为 79.4 % ,对照组为 2 1.7% ,差异有统计学意义 (P <0 .0 1)。结论 :rhEPO 4 0 0 0 0U/周对晚期结、直肠癌联合方案化疗相关贫血有肯定的疗效     

Circadian rhythm of serum erythropoietin in multiple myeloma

The diurnal rhythm in the circulating serum levels of erythropoietin (EPO) were determined in a group of 20 adult clinically-healthy subjects, in a group of 10 patients with myeloma without renal impairment and 10 patients with myeloma and renal failure. Venous blood samples were drawn during the span of a whole day and every 4 hr, starting from midnight, for the measurement of serum EPO levels by radioimmunoassay (RIA). Statistical analysis was carried out by means of the “cosinor” method. Results show that the controls and the myeloma patients without renal insufficiency present significant (P < 0.05) circadian rhythms in serum EPO levels; no rhythm (P < 0.05) was detected in patients with myeloma and renal failure. Patients with myeloma and renal failure have significant (P < 0.05) lower mean daily levels and diurnal fluctuations of EPO than the other groups, whereas the patients with myeloma without renal involvement present higher (P < 0.05) mean daily levels and lower (P < 0.05) diurnal variations of EPO than controls; no differences (P > 0.05) exist between the groups regarding peaks of rhythms. These data confirm the existence of a physiological circadian rhythm in serum EPO concentrations, with maximum in the afternoon, and they suggest that renal failure is an important cause of anemia and loss of EPO circadian rhythm in patients with myeloma. © 1996 Wiley-Liss, Inc.     

Recombinant human erythropoietin for the treatment of the anaemia associated with autologous bone marrow transplantation

Summary. Patients with solid tumours undergoing highdose chemotherapy with autologous bone marrow transplantation use an average of 10 units of packed red blood cells (PRBC) while awaiting haemopoietic reconstitution. They are also known to have inappropriately low endogenous erythropoietin levels for their degree of anaemia. This pilot study was designed to determine the effects of recombinant human erythropoietin (rHuEPO) on erythroid recovery and PRBC transfusion requirements. Ten patients received high-dose chemotherapy (days - 7 to -3), bone marrow reinfusion (day 0), and then rHuEPO (day 1 onward). RHuEPO (200 units/kg intravenous bolus daily), along with iron supplementation, was administered for 28 d or until a haematocrit (Hct) of 35% (independent of transfusions) was reached, whichever occurred first. PRBCs were routinely given for Hct 25% and platelets for counts < 20000/μl. Eight (80%) patients developed a brisk reticulocytosis (median peak reticulocyte count 0.32 × 10⁹/l) and a haematocrit 30% independent of red blood cell transfusions within 32 d of receiving marrow, as compared to 20/37 (54%) similarly treated controls. An unexpected finding was the more rapid engraftment in myeloid and platelet lineages in a subset of rHuEPO-treated patients. Quick return of red blood cells (17 v 33d) (P = 0.0001), platelets (14 v 19d) (P = 0.04), and neutrophils (13 v 25d) (P = 0.01) (with circulating myeloblasts and early myeloid forms) characterized recovery from an ifosfamide-based intensification with rHuEPO support. Similar trilineage enhancement of haemopoiesis did not occur with the possibly more myeloablative cyclophosphamide-based regimens. Despite the enhancement by rHuEPO on reticulocytosis, there was no significant decrease in PRBC transfusion requirements. RHuEPO proved to be a well-tolerated agent in enhancing reticulocytosis following high-dose chemotherapy. further study to elucidate the activity of erythropoietin on both erythroid and non-erythroid growth and maturation appears warranted.     

促红细胞生成素冲击方法治疗化疗相关贫血的临床研究

目的比较重组人促红细胞生成素(rhEPO)冲击剂量治疗法与常规剂量治疗法治疗肿瘤化疗相关贫血的疗效。方法根据NCCN《癌症及其治疗相关贫血治疗指南》〔1〕,选择64例恶性肿瘤联合化疗后贫血患者(Hb<11g/L),所有病例均经病理或细胞学检查确诊。分组rhEPO冲击治疗组28例(冲击组)和rhEPO常规治疗组(36例)。冲击组rhEPO20000u,1次/d,连用2d,10000u,1次/d,连用6d,即在8d内共用100000u。随后同常规组。常规组40000u/周,皮下注射(SC)。812周。分别于治疗后第2、4、6、8周评定疗效。结果冲击组和常规组基础Hb水平分别为(90±10)g/L和(93±9)g/L;治疗后2周Hb增涨分别为(18.8±7.9)g/L和(9.2±6.3)g/L;治疗后4周Hb增加分别为(32.7±7.8)g/L和(19.2±7.8)g/L;治疗后6周rhEPOHb增加(38.7±8.8)g/L和(27.2±7.4)g/L,治疗后8周rhEPOHb增加分别为(41.0±8.9)g/L和(29.3±9.9)g/L。冲击剂量组和常规剂量组相比差异有统计学意义(P<0.01)。rhEPO冲击剂量治疗组总有效率为84.4%;常规剂量治疗组总有效率为77.8%,差异有显著统计学意义(P<0.01)。结论rhEPO冲击治疗方法能快速纠正联合方案化疗所致贫血,能为顺利完成化疗提供有力的保障;而且安全能够耐受。     

Efficacy of epoetin alfa in the treatment of anaemia of multiple myeloma

Effects of epoetin alfa on transfusions, haemoglobin (Hb) and quality of life (QOL) were evaluated in a placebo-controlled study of 145 patients with multiple myeloma and anaemia (Hb < 11 g/dl). During the 12-week, double-blind phase, patients received 150 IU/kg epoetin alfa or a matching volume of placebo subcutaneously three times weekly; the dose (or volume) was doubled at week 4 if Hb response was inadequate. Patients completing this phase could enter the subsequent optional 12-week phase of open-label epoetin alfa treatment. During double-blind treatment, epoetin alfa significantly decreased the incidence of transfusion compared with placebo (28% vs. 47%, P = 0.017), regardless of patients' transfusion history, and increased mean Hb (1.8 g/dl vs. 0.0 g/dl, P < 0.001). Univariate analysis showed significant (P 相似文献   

Danish patients with untreated multiple myeloma do not harbour human herpesvirus 8

The role of human herpesvirus 8 (HHV-8) in multiple myeloma (MM) remains controversial. We examined 15 Danish MM patients before cytoreductive therapy. Mononuclear cells isolated from peripheral blood and bone marrow aspirates, as well as long-term cultured bone marrow stromal cells, were assayed for the presence of HHV-8 DNA. All material was tested by three simple unnested polymerase chain reaction (PCR) assays (amplifying regions of ORF26, ORFK1 and ORF75) and two nested PCR assays (amplifying regions of ORF26). HHV-8 was not demonstrated in any of the samples. Our findings do not suggest an association between HHV-8 and MM in the Danish population.     

Erythropoietin response in anaemic patients with multiple myeloma and other lymphoid malignancies infiltrating the bone marrow.

Immunoreactive erythropoietin levels were measured in 42 patients with lymphoid malignancies with anaemia and bone marrow involvement. Results were compared to a control group of 16 patients suffering from anaemia due to other causes. Significant inverse correlations between serum erythropoietin level and haemoglobin concentration were shown for the patients with lymphoid malignancies and also for the control subjects. Overall, the erythropoietin levels of patients with lymphoid malignancies with bone marrow infiltration and with normal renal function did not differ significantly from erythropoietin levels of the anaemic controls. We conclude that anaemia in patients with lymphoproliferative disorders with bone marrow infiltration and normal renal function is caused primarily by a diminished/inadequate response to erythropoietin at the level of the target cell.     

硼替佐米联合地塞米松治疗多发性骨髓瘤临床研究

目的观察硼替佐米联合地塞米松(PD)在多发性骨髓瘤(MM)中的应用。方法 2008年2月至2010年4月北京积水潭医院36例MM患者接受PD治疗。以同期46例VADT化疗的MM患者做为对照。分析病情转归及不良反应。结果 (1)PD用于初治和复发和(或)难治MM患者疗效均显著。初治组治疗有效率85.7%(18/21);复发和(或)难治组的有效率为80.0%(12/15);总有效率为83.3%(30/36)。PD与VADT治疗初治MM的有效率差异无统计学意义(85.7%对78.1%,P=0.740),PD治疗复发和(或)难治MM的有效率明显高于VADT组(80.0%对42.9%,P=0.039)。PD起效快,治疗有效的患者均在1个疗程后达PR;63.9%患者在3个疗程内达到VGPR以上缓解,优于VADT组的30.4%。(2)PD不良反应主要有乏力、周围神经病变及血小板减少等。PD治疗初治MM较复发和(或)难治MM不良反应小,耐受性好,更能坚持长期化疗以获得最大缓解。(3)PD治疗的MM患者骨痛缓解快,全身骨密度增高较VADT组更显著[(1.138±0.102)g/cm2对(1.053±0.137)g/cm2,P=0.039)]。结论硼替佐米联合地塞米松治疗MM缓解率高,可首选用于治疗初治及复发和(或)难治MM。