Avtor/Urednik		Mlakar, Uroš
Naslov		Indikacije za zdravljenje z eritropoetinom
Prevedeni naslov		Indications for treatment with erythropoietin
Tip		članek
Vir		In: Križman I, editor. Interna medicina 2005: novosti in aktualnosti. Zbornik predavanj 2. kongres Združenja internistov SZD; 2005 okt 21-22; Ljubljana. Ljubljana: Slovensko zdravniško društvo, Združenje internistov,
Leto izdaje		2005
Obseg		str. 209-13
Jezik		slo
Abstrakt		The use of recombinant human erythropoietin (rHuEpo, epoetin) for treatment of renal anemia can be regarded as the gold standard of erythropoietin (Epo) therapy. Current treatment guidelines recommends giving epoetin as soon as hemoglobin (Hb) concentration falls below 110 g/L and alternative causes of anemia have been ruled out. Despite the use of epoetin for more than a decade in treating renal anemia, there is still debate over optimal target hemoglobin levels. Anemia is a frequent finding in cancer patients and is a result of their disease or treatment. Additional causes of anemia such as iron deficiency, bleeding, nutritional defects or hemolysis should be corrected prior to epoetin therapy. European Organisation for Research and Treatment of Cancer recommends the use of epoetin in patients with solid tumors or lymphoid neoplasms who have anemia of chronic inflammation or chemotherapy (radiotherapy) - induced anemia. Treatment with epoetin should be initiated at an Hb level of 90-110 g/L based on anemia-related symptoms. Epoetin may be considered in asymptomatic anemic patients (Hb 90-110 g/L), to prevent a further decline in Hb, according to individual factors (e.g., type/intensily of chemotherapy, baseline Hb). Low serum Epo level, in particular in patients with lymphoid neoplasms, is the only verified prognostic factor of response to epoetin of some importance. There is strong evidence that epoetin + filgrastim (G-CSF) can correct anemia in about 45% of low-risk myelodysplastic syndromes, with synergistic effect between the two drugs. Low pretreatment serum Epo levels (<500 U/L) and low transfusion requirements (<2 RBC units/month) are favorable prognostic factor of response. A number of studies in the last few years have shown that anemia is common in patients with chronic heart failure. Amelioration of anemia with epoetin combined with iv iron involves significant improvements in both cardiac and renal function. (Abstract truncated at 2000 characters)
Deskriptorji		ERYTHROPOIETIN, RECOMBINANT KIDNEY FAILURE, CHRONIC NEOPLASMS ANEMIA