medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-10-134-139medsovet-2544Research ArticleОбзорыReviewsРоль эритропоэтинов в лечении онкологических больныхThe role of erythropoietins in cancer therapyКондратьеваО. Е.KondratievaO. E.АбрамовМ. Е.AbramovM. E.

Кандидат медицинских наук

Москва

ВышинскаяГ. В.VyshinskayaG. V.

Доктор медицинских наук

Москва

ГуторовС. Л.GutorovS. L.

Доктор медицинских наук

Москва

БорисоваЕ. И.BorisovaE. I.

Кандидат медицинских наук 

Москва

ЧерноглазоваЕ. В.CherniglazovaE. V.

Кандидат медицинских наук 

Москва

ФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияN.N.Blokhin National Medical Research Cancer Centre of Oncology, Federal State Budgetary Institution of the Ministry of Health of RussiaRussian Federation201818072018010134139Copyright © Кондратьева О.Е., Абрамов М.Е., Вышинская Г.В., Гуторов С.Л., Борисова Е.И., Черноглазова Е.В., 20182018Кондратьева О.Е., Абрамов М.Е., Вышинская Г.В., Гуторов С.Л., Борисова Е.И., Черноглазова Е.В.Kondratieva O.E., Abramov M.E., Vyshinskaya G.V., Gutorov S.L., Borisova E.I., Cherniglazova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2544

Анемия является распространенным гематологическим осложнением у онкологических пациентов, получающих химиотерапию. Снижение уровня гемоглобина сопровождается значительным ухудшением качества жизни пациентов. В случае развития симптомной анемии с целью быстрого увеличения уровня гемоглобина применяется переливание эритроцитарной массы. Однако большое число рисков ограничивает широкое применение гемотрансфузий. Препаратами, которые позволяют снизить потребность в гемотрансфузиях, являются эритропоэзстимулирующие протеины. Эритропоэтины обеспечивают плавный и пролонгированный подъем уровня гемоглобина, выход в кровь функционально полноценных эритроцитов. Использование эритропоэтинов позволяет значительно улучшить качество жизни онкологических больных, не снижая эффективности проводимой химиотерапии.

Anemia is a common hematological complication in cancer patients receiving chemotherapy. Reduction of hemoglobin level is accompanied by a significant deterioration in the patients’ life quality. A transfusion of erythrocyte mass is used to rapidly increase the hemoglobin level in case of development of a symptomatic anemia. However, a large range of risks limit the wide use of blood transfusions. Erythropoiesis-stimulating proteins are the drugs that reduce the need for blood transfusions. Treatment with erythropoietins provides a smooth and prolonged rise in the hemoglobin level, the release of fully functional red blood cells into the blood. The use of erythropoietins can significantly improve the quality of life of cancer patients without reducing the effectiveness of chemotherapy.

анемияэритропоэтиныгемоглобинхимиотерапиякачество жизниanemiaerythropoietinshemoglobinchemotherapyquality of lifeReferencesLudwig H, Van BS, Barrett-Lee P et al. The European Cancer Anaemia Survey: a large, multinational, prospective survey defining the prevalence, incidence and treatment of anaemia in cancer patients. Eur. J. Cancer, 2004, 40: 2293-306.Ludwig H, Van BS, Barrett-Lee P et al. The European Cancer Anaemia Survey: a large, multinational, prospective survey defining the prevalence, incidence and treatment of anaemia in cancer patients. Eur. J. Cancer, 2004, 40: 2293-306.Caro JJ, Salas M, Ward A. et al. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer, 2001, 91(12): 2214-2221.Caro JJ, Salas M, Ward A. et al. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer, 2001, 91(12): 2214-2221.RUSSCO – практические рекомендации по поддерживающей терапии в онкологии. 2017, с. 464.RUSSCO: practical guidelines for maintenance therapy in oncology. 2017, p. 464.Auerbach M, Silberstein PT, Webb RT et al. Darbepoetin alfa 300 or 500 mg once every 3 weeks with or without intravenous iron in patients with chemotherapyinduced anemia. Am. J. Hematol, 2010, 85: 655–63.Auerbach M, Silberstein PT, Webb RT et al. Darbepoetin alfa 300 or 500 mg once every 3 weeks with or without intravenous iron in patients with chemotherapyinduced anemia. Am. J. Hematol, 2010, 85: 655–63.Henry DH, Dahl NV, Auerbach M et al. Intravenous ferric gluconate significantly improves response to epoetin alfa versus oral iron or no iron in anemic patients with cancer receiving chemotherapy. Oncologist, 2007, 12: 231–42.Henry DH, Dahl NV, Auerbach M et al. Intravenous ferric gluconate significantly improves response to epoetin alfa versus oral iron or no iron in anemic patients with cancer receiving chemotherapy. Oncologist, 2007, 12: 231–42.Птушкин В.В. Анемии и дефицит железа у онкологических больных. Клиническая онкогематология, 2013, 6(1): 91-96.Ptushkin VV. Anemia and iron deficiency in cancer patients. Clinicheskaya Oncohematologiya, 2013, 6 (1): 91-96.NCCN Guidelines версия 1.2018. Cancer and chemotherapy-induced anemia.NCCN Guidelines версия 1.2018. Cancer and chemotherapy-induced anemia.Witzig TE, Silberstein PT, Loprinzi CL et al. Phase III, randomized, double-blind study of epoetin alfa compared with placebo in anemic patients receiving chemotherapy. J Clin Oncol, 2005 Apr 20, 23(12): 2606-17.Witzig TE, Silberstein PT, Loprinzi CL et al. Phase III, randomized, double-blind study of epoetin alfa compared with placebo in anemic patients receiving chemotherapy. J Clin Oncol, 2005 Apr 20, 23(12): 2606-17.Bohlius J, Tonia T, Schwarzer G. Twist and shout: one decade of meta-analyses of erythropoiesis-stimulating agents in cancer patients. Acta Haematol, 2011, 125(1-2): 55-67.Bohlius J, Tonia T, Schwarzer G. Twist and shout: one decade of meta-analyses of erythropoiesis-stimulating agents in cancer patients. Acta Haematol, 2011, 125(1-2): 55-67.Quirt I, Robeson C, Lau CY et al. Epoetin alfa therapy increases hemoglobin levels and improves quality of life in patients with cancer-related anemia who are not receiving chemotherapy and patients with anemia who are receiving chemotherapy. J Clin Oncol, 2001 Nov 1, 19(21): 4126-34.Quirt I, Robeson C, Lau CY et al. Epoetin alfa therapy increases hemoglobin levels and improves quality of life in patients with cancer-related anemia who are not receiving chemotherapy and patients with anemia who are receiving chemotherapy. J Clin Oncol, 2001 Nov 1, 19(21): 4126-34.Demetri GD, Kris M, Wade J, Degos L, Cella D. Quality-of-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: results from a prospective community oncology study. Procrit Study Group. J Clin Oncol, 1998 Oct, 16(10): 3412-25.Demetri GD, Kris M, Wade J, Degos L, Cella D. Quality-of-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: results from a prospective community oncology study. Procrit Study Group. J Clin Oncol, 1998 Oct, 16(10): 3412-25.Glaspy J, Degos L, Dicato M, Demetri GD. Comparable efficacy of epoetin alfa for anemic cancer patients receiving platinumand nonplatinum-based chemotherapy: a retrospective subanalysis of two large, community-based trials. Oncologist, 2002, 7(2): 126-35.Glaspy J, Degos L, Dicato M, Demetri GD. Comparable efficacy of epoetin alfa for anemic cancer patients receiving platinumand nonplatinum-based chemotherapy: a retrospective subanalysis of two large, community-based trials. Oncologist, 2002, 7(2): 126-35.Jens-Uwe Blohmer, Stefan Paepke and et al. Randomized phase III trial of sequential adjuvant chemoradiotherapy with or without erythropoietin Alfa in patients with high-risk cervical cancer: results of the NOGGO-AGO intergroup study. J Clin Onco, 2011 Oct 1, 29(28): 3791-7.Jens-Uwe Blohmer, Stefan Paepke and et al. Randomized phase III trial of sequential adjuvant chemoradiotherapy with or without erythropoietin Alfa in patients with high-risk cervical cancer: results of the NOGGO-AGO intergroup study. J Clin Onco, 2011 Oct 1, 29(28): 3791-7.Volker Moebus, Christian Jackisch and etc. Adding epoetin alfa to intense dose-dense adjuvant chemotherapy for breast cancer: randomized clinical trial. J Natl Cancer Inst, 2013 Jul 17, 105(14): 1018-26.Volker Moebus, Christian Jackisch and etc. Adding epoetin alfa to intense dose-dense adjuvant chemotherapy for breast cancer: randomized clinical trial. J Natl Cancer Inst, 2013 Jul 17, 105(14): 1018-26.Henry DH, Dahl NV, Auerbach M, Tchekmedyian S, Laufman LR. Intravenous ferric gluconate significantly improves response to epoetin alfa versus oral iron or no iron in anemic patients with cancer receiving chemotherapy. Oncologist, 2007 Feb, 12(2): 231-42.Henry DH, Dahl NV, Auerbach M, Tchekmedyian S, Laufman LR. Intravenous ferric gluconate significantly improves response to epoetin alfa versus oral iron or no iron in anemic patients with cancer receiving chemotherapy. Oncologist, 2007 Feb, 12(2): 231-42.Pedrazzoli P, Farris A, Del Prete S and et al. Randomized trial of intravenous iron supplementation in patients with chemotherapyrelated anemia without iron deficiency treated with darbepoetin alpha. J Clin Oncol, 2008 Apr 1, 26(10): 1619-25.Pedrazzoli P, Farris A, Del Prete S and et al. Randomized trial of intravenous iron supplementation in patients with chemotherapyrelated anemia without iron deficiency treated with darbepoetin alpha. J Clin Oncol, 2008 Apr 1, 26(10): 1619-25.Hedenus M, Birgegård G, Näsman P and 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 Apr, 21(4): 627-32.Hedenus M, Birgegård G, Näsman P and 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 Apr, 21(4): 627-32.Steensma DP, Sloan JA, Dakhil SR and et al. Phase III, randomized study of the effects of parenteral iron, oral iron, or no iron supplementation on the erythropoietic response to darbepoetin alfa for patients with chemotherapy-associated anemia. J Clin Oncol, 2011 Jan 1, 29(1): 97-105.Steensma DP, Sloan JA, Dakhil SR and et al. Phase III, randomized study of the effects of parenteral iron, oral iron, or no iron supplementation on the erythropoietic response to darbepoetin alfa for patients with chemotherapy-associated anemia. J Clin Oncol, 2011 Jan 1, 29(1): 97-105.Granetto C1, Ricci S, Martoni A and et al. Comparing the efficacy and safety of fixed versus weight-based dosing of epoetin alpha in anemic cancer patients receiving platinum-based chemotherapy. Oncol Rep, 2003 Sep-Oct, 10(5): 1289-96.Granetto C1, Ricci S, Martoni A and et al. Comparing the efficacy and safety of fixed versus weight-based dosing of epoetin alpha in anemic cancer patients receiving platinum-based chemotherapy. Oncol Rep, 2003 Sep-Oct, 10(5): 1289-96.Henry DH1, Gordan LN, Charu V and et al. Randomized, open-label comparison of epoetin alfa extended dosing (80 000 U Q2W) vs weekly dosing (40 000 U QW) in patients with chemotherapy-induced anemia. Curr Med Res Opin, 2006 Jul, 22(7): 1403-13.Henry DH1, Gordan LN, Charu V and et al. Randomized, open-label comparison of epoetin alfa extended dosing (80 000 U Q2W) vs weekly dosing (40 000 U QW) in patients with chemotherapy-induced anemia. Curr Med Res Opin, 2006 Jul, 22(7): 1403-13.Waltzman R, Croot C, Justice GR and et al. Randomized comparison of epoetin alfa (40,000 U weekly) and darbepoetin alfa (200 microg every 2 weeks) in anemic patients with cancer receiving chemotherapy. Oncologist, 2005 Sep, 10(8): 642-50.Waltzman R, Croot C, Justice GR and et al. Randomized comparison of epoetin alfa (40,000 U weekly) and darbepoetin alfa (200 microg every 2 weeks) in anemic patients with cancer receiving chemotherapy. Oncologist, 2005 Sep, 10(8): 642-50.U.S. Food and Drug Administration.U.S. Food and Drug Administration.Spano JP, Khayat D. Treatment options for anemia, taking risks into consideration: erythropoiesis-stimulating agents versus transfusions. Oncologist, 2008, 13(Suppl 3): 27-32.Spano JP, Khayat D. Treatment options for anemia, taking risks into consideration: erythropoiesis-stimulating agents versus transfusions. Oncologist, 2008, 13(Suppl 3): 27-32.Witzig TE, Silberstein PT, Loprinzi CL and et al. Phase III, randomized, double-blind study of epoetin alfa compared with placebo in anemic patients receiving chemotherapy. J Clin Oncol, 2005 Apr 20, 23(12): 2606-17.Witzig TE, Silberstein PT, Loprinzi CL and et al. Phase III, randomized, double-blind study of epoetin alfa compared with placebo in anemic patients receiving chemotherapy. J Clin Oncol, 2005 Apr 20, 23(12): 2606-17.Bohlius J, Tonia T, Schwarzer G. Twist and shout: one decade of meta-analyses of erythropoiesis-stimulating agents in cancer patients. Acta Haematol, 2011, 125(1-2): 55-67.Bohlius J, Tonia T, Schwarzer G. Twist and shout: one decade of meta-analyses of erythropoiesis-stimulating agents in cancer patients. Acta Haematol, 2011, 125(1-2): 55-67.Cabanillas ME, Kantarjian H, Thomas DA and et al. Epoetin alpha decreases the number of erythrocyte transfusions in patients with acute lymphoblastic leukemia, lymphoblastic lymphoma, and Burkitt leukemia/lymphoma: results of a randomized clinical trial. Cancer, 2012 Feb 1, 118(3): 848-55.Cabanillas ME, Kantarjian H, Thomas DA and et al. Epoetin alpha decreases the number of erythrocyte transfusions in patients with acute lymphoblastic leukemia, lymphoblastic lymphoma, and Burkitt leukemia/lymphoma: results of a randomized clinical trial. Cancer, 2012 Feb 1, 118(3): 848-55.Pashos CL, Larholt K, Fraser KA and et al. Outcomes of erythropoiesis-stimulating agents in cancer patients with chemotherapy-induced anemia. Support Care Cancer, 2012 Jan, 20(1): 159-65.Pashos CL, Larholt K, Fraser KA and et al. Outcomes of erythropoiesis-stimulating agents in cancer patients with chemotherapy-induced anemia. Support Care Cancer, 2012 Jan, 20(1): 159-65.

The authors declare that there are no conflicts of interest present.