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[Prognostic value of a number of blood laboratory parameters in the use of erythropoiesis-stimulating agents in anemic patients with lymphoproliferative diseases].
- Source :
-
Terapevticheskii arkhiv [Ter Arkh] 2013; Vol. 85 (8), pp. 81-6. - Publication Year :
- 2013
-
Abstract
- Aim: To clarify the prognostic value of the baseline blood levels of endogenous erythropoietin (EE) and tumor necrosis factor-a (TNF-a) 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.<br />Subjects 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=1 3), 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-alpha 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.<br />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 o EE ( <130 mlU/ml) and TNF- alfa (,15 pg/ml) were ascertained to show a positive response more frequently (80 and 92.9%, respectively; p<0.05) than those with thepredicting the efficacy of ESAs. The patients with the decreased baseline concentrations of EE (<130 mlU/ml) and TNF-a (<15 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 100-10(9)/1 (70%; p=0.05).<br />Conclusion: Estimating the baseline blood levels of EE and TNF-a 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.
- Subjects :
- Adult
Aged
Aged, 80 and over
Anemia drug therapy
Erythropoietin blood
Female
Hematologic Tests standards
Humans
Lymphoproliferative Disorders drug therapy
Male
Middle Aged
Severity of Illness Index
Treatment Outcome
Tumor Necrosis Factor-alpha blood
Young Adult
Anemia blood
Hematinics pharmacology
Lymphoproliferative Disorders blood
Predictive Value of Tests
Subjects
Details
- Language :
- Russian
- ISSN :
- 0040-3660
- Volume :
- 85
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Terapevticheskii arkhiv
- Publication Type :
- Academic Journal
- Accession number :
- 24137969