Prognostic value of a number of blood laboratory parameters in the use of erythropoiesis-stimulating agents in anemic patients with lymphoproliferative diseases
- Authors: Romanenko NA1, Bessmel'tsev SS1, Berkos MV1, Rozanova OE1, Abdulkadyrov KM1
-
Affiliations:
- Российский НИИ гематологии и трансфузиологии ФМБА России
- Issue: Vol 85, No 8 (2013)
- Pages: 81-86
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/31338
- ID: 31338
Cite item
Full Text
Abstract
AIM: To clarify the prognostic value of the baseline blood levels of endogenous erythropoietin (EE) and tumor necrosis factor-α (TNF-α) involved in the key components of the pathogenesis of anemia in lymphoproliferative diseases (LPD), the counts of reticulocytes and platelets (hematopoietic preservation indicators) in the use of erythropoiesis-stimulating agents (ESAs) to correct anemia syndrome (AS) in patients with LPD/MATERIAL AND METHODS: The results of AS treatment with ESAs were analyzed in 48 patients with LPD. A study group comprised patients with chronic lymphocytic leukemia (n=13), indolent lymphomas (n=14), and multiple myeloma (n=21). Their hemograms (hemoglobin concentration, red blood cells, packed cell volume, reticulocytes, and platelets) and blood EE and TNF-α levels were examined before using ESAs. The hemogram was monitored during treatment. ESAs (eralfon (epoietin alpha) in 21 patients and epres in 27) were subcutaneously injected in a dose of 150 IU/kg thrice weekly (for not more than 16 weeks). A control group included 21 anemic patients with multiple myeloma who did not receive ESAs. Increasing hemoglobin concentrations up to 120 g/l was regarded as a positive response to ESA treatment/RESULTS: By and large, the efficacy of epoietin alpha was 62.5% (61.9% for eralfon and 63.0% for epres), which was significantly higher than that in the control group (23.4%; p<0.05). A number of blood laboratory parameters were found to be of value in predicting the efficacy of ESAs. The patients with the decreased baseline concentrations of EE (<130 mIU/ml) and TNF-α (<15 pg/ml) were ascertained to show a positive response more frequently (80 and 92.9%, respectively; p<0.05) than those with the elevated concentrations of the enzymes in question. In addition, a positive response was more often recorded in patients with reticulocyte counts of more than 1% (77.4%; p<0.05) and platelets of 100·109/l (70%; p=0.05)/CONCLUSION: Estimating the baseline blood levels of EE and TNF-α and the counts of reticulocytes and platelets prior to the use of ESAs enables prediction of the efficiency of erythropoiesis-stimulating therapy in anemic patients with LPD.
Full Text
##article.viewOnOriginalSite##About the authors
N A Romanenko
Российский НИИ гематологии и трансфузиологии ФМБА России
Email: rom-nik@yandex.ru
S S Bessmel'tsev
Российский НИИ гематологии и трансфузиологии ФМБА России
M V Berkos
Российский НИИ гематологии и трансфузиологии ФМБА России
O E Rozanova
Российский НИИ гематологии и трансфузиологии ФМБА России
K M Abdulkadyrov
Российский НИИ гематологии и трансфузиологии ФМБА России
References
- Dammacco F., Luccarelli G., Prete M., Silvestris F. The role of recombinant human erythropoietin alpha in the treatment of chronic anemia in multiple myeloma. Rev Clin Exp Hematol 2002; 1: 32-38.
- Moullet I., Salles G., Ketterer N. et al. Frequency and significance of anemia in non-Hodgkin's lymphoma patients. Ann Oncol 1998; 9: 1109-1115.
- Приказ Минздрава РФ №363 от 25 ноября 2002 г. "Об утверждении Инструкции по применению компонентов крови". Доступно на http://www.spid.ru/10/pic/100310.pdf
- Романенко Н.А., Абдулкадыров К.М. Применение препаратов рекомбинантного эритропоэтина у больных лимфопролиферативными заболеваниями. Медицинская технология Ст-Петербург; 2011.
- Бессмельцев С.С., Абдулкадыров К.М. Множественная миелома. Современный взгляд на проблему. Алматы 2007.
- Романенко Н.А. Коррекция и лечение анемии у больных с гемобластозами эритроцитсодержащими компонентами крови и препаратами рекомбинантного эритропоэтина. Вестн гематол 2007; 3: 46-54.
- Павлов А.Д., Морщакова Е.Ф., Румянцев А.Г. Эритропоэз, эритропоэтин, железо. М: ГЭОТАР-Медиа 2011.
- Поспелова Т.И., Лямкина А.С. Уровень цитокинов (интерлейкина-1Β, фактора некроза опухолей-α, интерферона-γ, интерлейкина-6) у больных лимфопролиферативными заболеваниями с анемическим синдромом. Анемия при лимфомах: научное издание. Новосибирск: НГМУ 2008: 97-114.
- Романенко Н.А., Абдулкадыров К.М. Патогенетическая коррекция анемии эритропоэзстимулирующими препаратами у больных лимфопролиферативными заболеваниями. Онкогематология 2011; 3: 39-49.
- Сараева Н.О. Механизмы развития анемии при гемобластозах. Гематология и трансфузиология 2007; 52 (1): 31-37.
- Цветаева Н.В., Левина А.А., Мамукова Ю.И. Основы регуляции обмена железа. Клин онкогематол 2010; 3: 278-283.
- Han B., Shi Y.K., Zhu J. et al. Study on serum erythropoietin levels in patients with hematologic malignancies. Zhonghua Xue Ye Xue Za Zhi 2006; 27 (8): 543-545.
- Shehata N., Walker I., Meyer R. et al. The use of erythropoiesis-stimulating agents in patients with non-myeloid hematological malignancies: a systematic review. Ann Hematol 2008; 87 (12): 961-973.
- Tsopra O.A., Ziros P.G., Lagadinou E.D. et al. Disease-related anemia in chronic lymphocytic leukemia is not due to intrinsic defects of erythroid precursors: a possible pathogenetic role for tumor necrosis factor-alpha. Acta Haematol 2009; 121 (4): 187-195.
- Henry D.H. Guidelines and recommendations for the management of anemia in patients with lymphoid malignancies. Drugs 2007; 67 (2): 175-194.
- Engert A., Josting A., Haverkamp H. et al. Epoetin alfa in patients with advanced-stage Hodgkin's lymphoma: results of the randomized placebo-controlled GHSG HD15EPO trial. J Clin Oncol 2010; 28 (13): 2239-2245.
- Гуревич К.Я., Константинов Ю.В., Коробицин Л.П. и др. Человеческий рекомбинантный эритропоэтин (эпокрин) в лечении анемии. Практическое руководство. СПб 2004.
- Бессмельцев С.С., Романенко Н.А., Абдулкадыров К.М. Современные подходы к лечению анемии у больных с онкогематологическими заболеваниями. Совр онкол 2010; 1: 70-75.
- Hunault-Berger M., Tanguy-Schmidt A., Rachieru P. et al. rHuEpo before high-dose therapy allows autologous peripheral stem-cell transplantation without red blood cell transfusion: a pilot study. Bone Marrow Transplant 2005; 35: 903-907.
- Beguin Y. Prediction of response to optimize outcome of treatment with erythropoietin. Semin Oncol 1998; 25 (3 Suppl. 7): 27-34.
- Hedenus M., Birgegård G., Näsman P. et al. Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study. Leukemia 2007; 21 (4): 627-632.
- Katodritou E., Speletas M., Zervas K. et al. Evaluation of hypochromic erythrocytes in combination with sTfR-F index for predicting response to r-HuEPO in anemic patients with multiple myeloma. Lab Hematol 2006; 12 (1): 47-54.
- Musto P., Falcone A.D'Arena et al. Clinical results of recombinant human erythropoietin in transfusion-dependent patients with refractory multiple myeloma; role of cytokines and monitoring of erythropoiesis. Eur J Haematol 1997; 58: 314-319.
- Romanenko N.A., Rozanova O.E., Glazanova T.V., Abdulkadyrov K.M. A study of the influence of TNF-alpha on the efficacy of treatment with recombinant erythropoietin in patients with lymphoproliferative disorders. Haematologica 2010; 95 (S2): 355-354.
- Katodritou E., Terpos E., Zervas K. et al. Hypochromic erythrocytes (%): a reliable marker for recognizing iron-restricted erythropoiesis and predicting response to erythropoietin in anemic patients with myeloma and lymphoma. Ann Hematol 2007; 86 (5): 369-376.
- Mittelman M. The implications of anemia in multiple myeloma. Clin Lymphoma 2003; 4 (Suppl 1): 23-29.
![](/img/style/loading.gif)