Use of erythropoietins in oncourological care

Abstract

Treatment of complications due to both early and end-stage urological cancers and those resulting from chemo- or radiotherapy is currently a topical problem.

Anemia in cancer patients is a complex syndrome that is caused by the disease and may be treatment induced with the blood level of hemoglobin being below the normal physiological range (< 12 g/dl).

A great number of causes of anemia are known in urologic cancer patients. These include chemotherapy for disseminated cancer of the testicle, urinary bladder, and prostate; radiotherapy for prostate cancer; concomitant chronic renal failure in renal cancer; metastatic bone marrow involvement in prostate, renal and urinary bladder cancers; hemorrhages in bladder tumors; profuse bleedings from the bladder and rectum in radiation-induced cystitis and rectitis. A reduction in the level of hemoglobin below the normal physiological range affects not only prognosis and quality of life, but also the course of the disease and the efficiency of specific treatment. Detection of anemia in urological cancer patients and its treatment are required to improve the quality of life and the indices of specific treatment.

In a malignant process, anemia is generally chronic and frequent blood transfusions substantially increase the risk for adverse reactions (transmission of viral infections, allergic and immunological reactions). The use of recombinant human erythropoietin is an alternative approach that has been recently widely used to correct and prevent anemia in cancer patients.

In the past 10 years, numerous prospective and retrospective studies dealing with the treatment of cancer-induced and postcytostatic anemia in patients with solid tumors and lymphoproliferative diseases. They have demonstrated the efficacy of erythropoietin alpha (Eprex®) that considerably increases blood hemoglobin levels and improves life quality indices.