摘要
目的：贫血是多发性骨髓瘤（multiple myeloma，MM）的常见并发症，人重组红细胞生成素（Recombinant human erythropoietin，rhEPO）可减轻骨髓瘤相关贫血，但目前rhEPO的最佳用量仍在探索中。此研究的目的是评价大剂量rhEPO治疗MM贫血的有效性和安全性。方法：64例均为我院在2005年2月～2006年12月收治的MM患者，采用开放性、随机对照研究，患者被随机分到rhEPO＋化疗组或单纯化疗组，前者除每月1次的化疗外，接受rhEPO 20，000u／天，皮下注射，在每月的第1～14天连续应用，共治疗3个月。结果：在治疗第1、2、3个月末时，未接受输血的患者中，Hb上升水平在rhEPO组（n=29）和单纯化疗组（n=26）分别为0．99±0．74vs0．19±0．86（P=0．722），1．78±1．48vs0．38±0．68（P=0．017）和2．67±1．54vs0．99±1．15（P=0．021）；Hb上升≥10g／L的患者，在rhEPO组和单纯化疗组分别为79．3％和46．2％，P〈0．001；Hb上升≥20g／L的患者，在两组分别为65．5％和23．1％，P=0．002。治疗3个月时，生存质量评分和体力状况评分的改善均在rhEPO组更加明显。与单纯化疗组相比，rhEPO组毒副作用无明显差别。结论：大剂量rhEPO治疗MM相关贫血，可有效快速提高患者的血红蛋白水平，改善患者的生活质量，耐受性较好，值得进一步临床研究。
Objective Anemia is a common complication of multiple myeloma （MM） patients. Recombinant human erythropoietin （rhEPO） can alleviate tumor-related anemia. However, the optimum dose of rhEPO is still under investigation. This study was conducted to evaluate the efficacy and safety of high-dose rhEPO in multiple myeloma patients with anemia who were receiving chemotherapy. Methods Sixty-four MM patients were enrolled from Feb, 2005 to Dec, 2006. In this open-labeled, randomized control trial, patients were divided into rhEPO ＋chemotherapy group and simple chemotherapy group. The former group received 20,000 U rhEPO subcutaneously on d1～ 14 each month for 3 months besides monthly chemotherapy. Results In the end of the first, second and third month, the elevated Hb value in rhEPO group （n=29） and chemotherapy group （n=26） who had not had blood transfusion were 0.99±0. 74 vs 0.19±0. 86（P=0. 722）,1.78±1.48 vs 0.38±0.68（P=0. 017）and 2.67±1.54vs 0. 99±1.15（P= 0.021）. To the patients who had an elevation of Hb more than 10g/L, they were 79. 3% and 46. 2% respectively in rhEPO group and in chemotherapy group （P= 0. 001 ）. To the patients who had an elevation of Hb more than 20 g/L, they were 65.5% and 23. 1% respectively（P=0. 002）, which rhEPO patients were significantly higher than that of chemotherapy patients, three months after the treatment, significant improvements could be observed in qulity of life （QOL） scores and performance scores in rhEPO group. On the other hand, adverse events were slight. Conclusion High-dose rhEPO can elevate Hb value effectively and rapidly, improve the patient＇s life quality, and it is well tolerated in treating MM related anemia. It is worth of further clinical study.
出处
《国际输血及血液学杂志》
CAS
2007年第4期305-308,共4页
International Journal of Blood Transfusion and Hematology
