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Title:Priporočila za uporabo rastnih dejavnikov za eritrocite pri sistemsko zdravljenih bolnikih z rakom
Authors:ID Humar, Mojca (Author)
ID Čufer, Tanja (Author)
Files:.pdf PDF - Presentation file, download (453,47 KB)
MD5: BB865CCF3A9C2E8F32AAD83D3CDBD6D7
PID: 20.500.12556/dirros/88b5a387-52b1-45df-83cf-b883016940eb
 
Language:Slovenian
Typology:1.04 - Professional Article
Organization:Logo OI - Institute of Oncology
Abstract:Rastni dejavniki za eritrocite (eritropoetini) so naravne beljakovine, ki jih večinoma tvorijo ledvice in ki sodelujejo pri uravnavanju tvorbe rdečih krvničk. Pri onkoloških bolnikih je vzrokov za razvoj anemije več. Pri kroničnih boleznih je najpogostejša normocitna in normokromna anemija, ki nastane zaradi slabšega odziva na eritropoetine in zaradi motene vgradnje železa v hemoglobin. Korekcija anemije izboljša kakovost življenja in zmanjša hipoksijo tumorja, s čimer naj bi se, glede na nekatere študije, povečala učinkovitost sistemskega in obsevalnega zdravljenja. Po začetnem navdušenju nad sintetičnimi eritropoetini (EPA), ki so se pokazali učinkoviti pri izboljšanju kakovosti življenja rakavih bolnikov z anemijo, pa je bilo v zadnjih letih objavljenih kar nekaj velikih raziskav, ki so pokazale več neželenih učinkov, predvsem trombemboličnih zapletov, in trend k slabšemu preživetju pri bolnikih na EPA. To je privedlo do močno okrnjenih priporočil za njihovo uporabo. Danes se uporaba EPA za korekcijo anemije priporoča samo pri bolnikih na specifičnem zdravljenju raka, katerega cilj ni ozdravitev. Zdravilo se uvede le ob simptomatski anemiji, odmerek se skrbno titrira do tarčnega Hb 120 g/L, pri večjih vrednostih Hb pa se EPA ne uporabljajo. Uporabo EPA je treba skrbno pretehtati pri bolnikih s tveganjem za razvoj trombemboličnih dogodkov. Za zdaj ne vemo, ali je nakazano slabše preživetje posledica stimulacije rasti tumorskih celic ali več neželenih učinkov, zlasti trombemboličnih zapletov, ob uporabi EPA. Dokončen odgovor na to in tudi podatke o optimalni rabi EPA pri rakavih bolnikih, nam bodo, upajmo, dali izsledki prospektivnih kliničnih raziskav, ki že potekajo.
Publication status:Published
Publication version:Version of Record
Year of publishing:2009
Number of pages:str. 106-109, 151
Numbering:Letn. 13, št. 2
PID:20.500.12556/DiRROS-8734 New window
UDC:616-006.6-085
ISSN on article:1408-1741
URN:URN:NBN:SI:doc-102KL8ZI
COBISS.SI-ID:847483 New window
Copyright:by Authors
Publication date in DiRROS:31.08.2018
Views:3105
Downloads:739
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Record is a part of a journal

Title:Onkologija
Shortened title:Onkologija
Publisher:Onkološki inštitut
ISSN:1408-1741
COBISS.SI-ID:65324032 New window

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:31.08.2018

Secondary language

Language:English
Title:Recommendations for the Use of Erythrocyte Colony Stimulating Factors in Systemic Treatment of Cancer
Abstract:Erythrocyte colony stimulating factors (erythropoietins) are natural proteins, mainly produced by kidneys. They take part in the regulation of red blood cells production. There are many causes for the development of anemia in cancer patients; the most frequent is anemia of chronic disease, which is normocytic and normochromic and results from a poor response to erythropoietins and invalid hemoglobin iron uptake. According to some studies, anemia correction increases quality of life (QOL) and decreases tumor hypoxia, thereby leading to a more efficient systemic and irradiation therapy. After the initial enthusiasm on synthetic erythropoietins (EPA), which showed to be effective in improving QOL in anemic cancer patients, some big trials published in the last years showed more side effects, especially thrombembolic complications and a trend towards a worse survival in patients on EPA. This led to strongly curtailed recommendations for their use. Today the use of EPA for anemia correction is recommended only for cancer patients on specific cancer treatment without curative intent. The drug is initiated only with symptomatic anemia, with careful titration of dose to a target Hb of 120 g/L, EPA should not be used with higher Hb values. A thoughtful consideration should be given to the use of EPA in the patients with a risk of thrombembolic events. We still do not know if slightly worse survivals are the consequence of tumor cell growth stimulation or of more side effects, especially thrombembolic complications with EPA usage. The final answer and also data on the optimal use of EPA in cancer patients will be provided, hopefully, by the results of ongoing prospective clinical trials.


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