Modern approaches to the treatment of anemia of malignant neoplasms

A. A. Pecherskikh, T. V. Parfenova, T. V. Pinchuk, N. Orlova, N. D. Karseladze, А. O. Bolshepaeva, О. A. Parfenova
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Abstract

Anemia in patients with cancer is a common concomitant condition. The development of anemia in cancer has a multifactorial pathogenesis, including inflammation, metastasis of solid tumors to the bone marrow and displacement of normal hematopoiesis sprouts in the bone marrow by tumor cells in hemoblastosis, myelosuppression against the background of chemo/radiation therapy, nutritional insufficiency due to anorexia, etc. Anemia in cancer patients reduces the quality of life, the response to antitumor therapy, increases the risk of tumor progression and is an independent factor negatively affecting survival. The article discusses the tactics of managing patients with anemia in accordance with the Clinical recommendations of the Ministry of Health of the Russian Federation “Anemia in malignant neoplasms” and “Management of CancerAssociated Anemia With Erythropoiesis-Stimulating Agents: ASCO/ASH Clinical Practice Guideline Update”. The results of clinical studies are presented, which indicate the effectiveness of the use of erythropoiesis-stimulating drugs (including epoetin alpha) in oncological practice, which reduce the need for hemotransfusions and increase hemoglobin levels in patients with anemia against the background of antitumor chemotherapy.
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治疗恶性肿瘤贫血的现代方法
癌症患者贫血是一种常见的并发症。癌症患者贫血的发病机理是多因素的,包括炎症、实体瘤转移至骨髓和骨髓中正常造血萌芽被血母细胞瘤中的肿瘤细胞取代、化疗/放疗背景下的骨髓抑制、厌食导致的营养不足等。癌症患者贫血会降低生活质量和对抗肿瘤治疗的反应,增加肿瘤进展的风险,是影响生存的一个独立不利因素。本文讨论了根据俄罗斯联邦卫生部临床建议 "恶性肿瘤中的贫血 "和 "使用促红细胞生成药物治疗癌症相关贫血 "管理贫血患者的策略:ASCO/ASH 临床实践指南更新"。临床研究结果表明,在抗肿瘤化疗的背景下,在肿瘤治疗中使用促红细胞生成药物(包括epoetin alpha)可以减少贫血患者的输血需求,提高血红蛋白水平。
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