Анемия у пациентов с онкологическими заболеваниями: значение парентеральных препаратов железа

Обзорная статья посвящена причинам, патогенезу и возможностям терапии анемии у онкологических пациентов. Проанализирован 61 источник, размещенный на платформе Pubmed и других научных базах. Анемия является одним из наиболее распространенных осложнений у пациентов с онкологическими заболеваниями и является значимым негативным прогностическим фактором, влияющим на качество жизни, переносимость противоопухолевой терапии и общую выживаемость. Ее развитие обусловлено множеством патогенетических механизмов, включая хроническую кровопотерю, метастатическое поражение костей, функциональный дефицит железа вследствие системного воспаления и миелотоксическое действие химиотерапии. Особое значение имеет диагностика анемии на ранних стадиях, поскольку ее наличие может служить маркером поздних стадий болезни, как, например, при колоректальном раке. Традиционные методы коррекции – гемотрансфузии и препараты, стимулирующие эритропоэз (ЭСП), имеют существенные ограничения. Гемотрансфузии связаны с риском иммунных реакций, инфекций и возможным ухудшением прогноза, тогда как применение ЭСП ассоциировано с повышенным риском тромботических осложнений и требует соблюдения строгих показаний. В этой связи особую актуальность приобретает использование внутривенных препаратов железа. Они эффективны как при абсолютном, так и при функциональном дефиците железа, позволяют повысить уровень гемоглобина, снизить потребность в трансфузиях и улучшить качество жизни пациентов. Современные исследования подтверждают безопасность и высокую эффективность монотерапии внутривенным железом, в т. ч. препаратами третьего поколения, такими как железа карбоксимальтозат. Коррекция анемии и дефицита железа играет ключевую роль в комплексном лечении онкологических больных, способствуя сохранению периодичности проведения терапии и улучшению ее результатов.

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