The Administration of Highdose Recombinant Human Erythropoietin in Multiple Myeloma Patients with Anemia_West China Medical Journal

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Department of Hematology,West China Hospital, Sichuan University, Chengdu Sichuan 610041,China ;

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Keywords：

多发性骨髓瘤; 贫血; 大剂量; 促红细胞生成素; 输血

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目的:多发性骨髓瘤(Multiple Myeloma,MM)患者约有80%伴有贫血,临床上多数患者以输血方式纠正贫血。重组人促红细胞生成素(recombinant human erythropoietin, rHuEPO)用于治疗MM患者的贫血尽管有效,但以何等剂量、应用多长时间疗效较佳尚无定论。目的: 观察持续使用大剂量rHuEPO对MM患者贫血的纠正作用及效果。方法:87例诊断明确的多发性骨髓瘤伴有贫血的患者,开始连续每天使用重组人促红细胞生成素4万单位,皮下注射,共5d;以后每周使用一次,每次4万单位皮下注射,间断补充铁剂。对照组90例选自同期住院的诊断明确的多发性骨髓瘤患者,当其贫血症状明显时或血红蛋白水平低于60 g/L时,给予输血纠正其贫血,使多数患者血红蛋白水平维持在80 g/L～100 g/L以上。两组患者化疗方案不做特殊规定,整过研究观察期6月。结果: rHuEPO组在使用rHuEPO后2周其血红蛋白开始上升,中位反应时间16d;1月半至2月血红蛋白可升至正常水平,达正常血红蛋白水平的中位时间51d。进入研究后3月和6月时,rHuEPO组生活幸福感指数(INLH)明显优于输血组,分别为6927±318(P lt;005)和7216±283(P lt;001)与5835±289和5776±324。6月后,rHuEPO组平均每例直接费用成本1075440元,明显低于输血组需要达到同样效果所需的每例2070420元。结论:大剂量rHuEPO治疗MM相关性贫血优于输血,其起效快、疗效好,患者生活幸福感改善明显,费用成本低,安全性较好。

Citation： LIU Yu,XU Juan,CHANG Hong,et al. The Administration of Highdose Recombinant Human Erythropoietin in Multiple Myeloma Patients with Anemia. West China Medical Journal, 2009, 24(5): 1147-1149. doi: Copy

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8.	CORTESI E, MANCUSO A, DE PASQUALE CERATTI A, et al. Effectiveness and safety of an induction therapy with epoetin alpha in anemic cancer patients receiving concomitant chemotherapy[J]. Oncologist,2004,9(4):459468.
9.	赵莹,李娟,罗绍凯,等.大剂量促红细胞生成素冲击在治疗多发性骨髓瘤贫血中的应用[J].国际输血及血液学杂志,2007,30(4):305308.

1.
2. 吴谨绪,邓承祺主编.血液病诊疗手册(第一版)[M].北京：人民卫生出版社,2000:152159.
3. LUDWIG H, POHL G, OSTERBORG A. Anemia in multiple myeloma[J]. Clin Adv Hematol Oncol,2004,2(4):233241.
4. BARLOGIE B, BECK T. Recombinant human erythropoietin and the anemia of multiple myeloma[J]. Stem Cell,1993,11:8894.
5. DAMMACCO F, LUCCARELLI G, PRETE M, et al. The role of recombinant human erythropoietin alpha in the treatment of chronic anemia in multiple myeloma[J]. Rev Clin Exp Hematol,2002(Suppl 1):3238.
6. MITTELMAN M, ZEIDMAN A, FRADIN Z, et al. Recombinant human erythropoietin in the treatment of multiple myelomaassociated anemia[J]. Acta Haematol,1997,98:204210.
7. DAMMCCO F, CASTOLDI G, RODJER S. Efficacy of epoetin alpha in the treatment of anemia of multiple myeloma[J]. Br J Haematol,2001,113(1):172179.
8. CORTESI E, MANCUSO A, DE PASQUALE CERATTI A, et al. Effectiveness and safety of an induction therapy with epoetin alpha in anemic cancer patients receiving concomitant chemotherapy[J]. Oncologist,2004,9(4):459468.
9. 赵莹,李娟,罗绍凯,等.大剂量促红细胞生成素冲击在治疗多发性骨髓瘤贫血中的应用[J].国际输血及血液学杂志,2007,30(4):305308.

West China Medical Journal

The Administration of Highdose Recombinant Human Erythropoietin in Multiple Myeloma Patients with Anemia

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