YU Qungang, CHEN Yafeng, WU Wenzhong. Clinical observation of recombinant human erythropoietin combined with iron agent in treatment of acute lymphoblastic leukemia complicated with mild to moderate anemia[J]. Journal of Clinical Medicine in Practice, 2023, 27(7): 84-88. DOI: 10.7619/jcmp.20222961
Citation: YU Qungang, CHEN Yafeng, WU Wenzhong. Clinical observation of recombinant human erythropoietin combined with iron agent in treatment of acute lymphoblastic leukemia complicated with mild to moderate anemia[J]. Journal of Clinical Medicine in Practice, 2023, 27(7): 84-88. DOI: 10.7619/jcmp.20222961

Clinical observation of recombinant human erythropoietin combined with iron agent in treatment of acute lymphoblastic leukemia complicated with mild to moderate anemia

More Information
  • Received Date: September 20, 2022
  • Revised Date: January 18, 2023
  • Available Online: April 22, 2023
  • Objective 

    To investigate the efficacy and safety of recombinant human erythropoietin (rHuEPO) combined with iron agent in treatment of patients with acute lymphoblastic leukemia (ALL) complicated with mild to moderate anemia.

    Methods 

    ALL patients with mild to moderate anemia were selected, and 200 patients who achieved complete response (CR) after induced response therapy were divided into control group and observation group with 100 patients in each group by coin toss. The control group was treated with iron, and the observation group was treated with rHuEPO combined with iron for 3 months. The clinical therapeutic effect of two groups was observed; the concentration of erythropoietin (EPO) was compared between the two groups after 1 month, 2 and 3 months of treatment; the levels of hemoglobin (HB), hematocrit (HCT), red blood cell (RBC), ferritin (SF) and adverse drug reactions before and after treatment were compared between the two groups.

    Results 

    The results of generalized estimation equation analysis showed that the serum EPO levels of the two groups at 2 and 3 months of treatment were significantly lower than that at 1 month, and the serum EPO levels of the observation group at 1 month, 2 and 3 months of treatment were significantly lower than that of the control group (P < 0.05). After 3 months of treatment, Hb, Hct and RBC levels in two groups were significantly higher than before treatment, and the observation group was significantly higher than the control group (P < 0.05). There was no significant difference in adverse drug reactions between the two groups (χ2=1.229, P=0.268).

    Conclusion 

    The rHuEPO combined with iron agent can regulate the level of serum EPO, increase the number of red blood cells and the levels of Hb, Hct, RBC and SF in patients with ALL complicated with mild to moderate anemia, and the drug safety is high.

  • [1]
    GHANEM S, GONSKY J. Recurrent anemia in a patient with chronic lymphocytic leukemia[J]. Cleve Clin J Med, 2022, 89(2): 91-98. doi: 10.3949/ccjm.89a.21025
    [2]
    PATTNAIK J, KAYAL S, DUBASHI B, et al. Profile of anemia in acute lymphoblastic leukemia patients on maintenance therapy and the effect of micronutrient supplementation[J]. Support Care Cancer, 2020, 28(2): 731-738. doi: 10.1007/s00520-019-04862-6
    [3]
    魏佳宁, 王凤, 卢蕻迪, 等. 149例老年患者肿瘤相关性贫血的临床分析[J]. 中国实验诊断学, 2018, 22(5): 865-867. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSZD201805036.htm
    [4]
    GASPAR B L, SHARMA P, DAS R. Anemia in malignancies: Pathogenetic and diagnostic considerations[J]. Hematology, 2015, 20(1): 18-25. doi: 10.1179/1607845414Y.0000000161
    [5]
    中华医学会血液学分会红细胞疾病(贫血)学组. 静脉铁剂应用中国专家共识(2019年版)[J]. 中华血液学杂志, 2019, 40(5): 358-362.
    [6]
    FENAUX P, SANTINI V, SPIRITI M A A, et al. A phase 3 randomized, placebo-controlled study assessing the efficacy and safety of epoetin-α in anemic patients with low-risk MDS[J]. Leukemia, 2018, 32(12): 2648-2658. doi: 10.1038/s41375-018-0118-9
    [7]
    中国抗癌协会血液肿瘤专业委员会, 中华医学会血液学分会白血病淋巴瘤学组. 中国成人急性淋巴细胞白血病诊断与治疗指南(2016年版)[J]. 中华血液学杂志, 2016, 37(10): 837-845. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXZ202203002.htm
    [8]
    葛均波, 徐永健, 王辰. 内科学[M]. 9版. 北京: 人民卫生出版社, 2018: 128-135.
    [9]
    YOUNG J, BADGERY-PARKER T, DOBBINS T, et al. Comparison of ECOG/WHO performance status and ASA score as a measure of functional status[J]. J Pain Symptom Manage, 2015, 49(2): 258-264. doi: 10.1016/j.jpainsymman.2014.06.006
    [10]
    GASCÓN P, KRENDYUKOV A, MATHIESON N, et al. Epoetin Alfa for the treatment of myelodysplastic syndrome-related anemia: a review of clinical data, clinical guidelines, and treatment protocols[J]. Leuk Res, 2019, 81: 35-42. doi: 10.1016/j.leukres.2019.03.006
    [11]
    BOHLIUS J, BOHLKE K, CASTELLI R, et al. Management of cancer-associated Anemia with erythropoiesis-stimulating agents: ASCO/ASH clinical practice guideline update[J]. J Clin Oncol, 2019, 37(15): 1336-1351. doi: 10.1200/JCO.18.02142
    [12]
    李莉, 张文龙, 张骥, 等. 老年血液系统恶性肿瘤合并贫血患者EPO和sTfR水平的测定及意义[J]. 癌症进展, 2018, 16(7): 908-910, 927. https://www.cnki.com.cn/Article/CJFDTOTAL-AZJZ201807031.htm
    [13]
    BANDACH I, SEGEV Y, LANDAU D. Experimental modulation of Interleukin 1 shows its key role in chronic kidney disease progression and anemia[J]. Sci Rep, 2021, 11(1): 6288. doi: 10.1038/s41598-021-85778-2
    [14]
    韩曦瑶, 刘立根, 李纲, 等. 重组人促红细胞生成素治疗前后慢性病贫血患者血清肿瘤坏死因子相关凋亡诱导配体水平测定及意义[J]. 中国老年学杂志, 2016, 36(15): 3795-3797. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ201615091.htm
    [15]
    SINHA S, PEREIRA-REIS J, GUERRA A, et al. The role of iron in benign and malignant hematopoiesis[J]. Antioxid Redox Signal, 2021, 35(6): 415-432.
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