Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press107910.17650/1726-9776-2007-3-1-10-16DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫUse of erythropoietins in oncourological careПрименение эритропоэтинов в онкоурологической практикеRusakovI. G.РусаковИ. Г.
Russian Federation
KalpinskyA. S.КалпинскийА. С.
Russian Federation
P.A. Herzen Moscow Research Oncological InstituteМосковский научно-исследовательский онкологический институт им. П.А. Герцена300320073110161502202015022020https://oncourology.abvpress.ru/oncur/article/view/1079

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.

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1. Groopman J.E., Itri L.M. Chemotherapy-induced anemia in adults: incidence and treatment. J Natl Cancer Inst 1999;91:1616—34.Groopman J.E., Itri L.M. Chemotherapy-induced anemia in adults: incidence and treatment. J Natl Cancer Inst 1999;91:1616—34.2. Ludwig H., Birgegard G., Barrett-Lee P. et al. Prevalence and management of anemia in patients with hematologic malignancies and solid tumors: results from the European Cancer Anaemia Survey. Blood 2002;100:234a—5a.Ludwig H., Birgegard G., Barrett-Lee P. et al. Prevalence and management of anemia in patients with hematologic malignancies and solid tumors: results from the European Cancer Anaemia Survey. Blood 2002;100:234a—5a.3. National Comprehensive Cancer Network, Cancer-and Treatment-Related Anemia, Practice Guidelines in Oncology. Vol. 2. 2006.National Comprehensive Cancer Network, Cancer-and Treatment-Related Anemia, Practice Guidelines in Oncology. Vol. 2. 2006.4. Nowrousian M.R. et al. Pathophysiology of cancer-related anemia. In: Smythe J. et al. Rh-erythropoietin in Cancer Supportive Treatment. NY, Marcel Dekker; 1996. p. 13—34.Nowrousian M.R. et al. Pathophysiology of cancer-related anemia. In: Smythe J. et al. Rh-erythropoietin in Cancer Supportive Treatment. NY, Marcel Dekker; 1996. p. 13—34.5. Means R.T. Jr. Pathogenesis of the anemia of chronic disease: a cytokinemediated anemia. Stem Cells 1995;13:32—37.Means R.T. Jr. Pathogenesis of the anemia of chronic disease: a cytokinemediated anemia. Stem Cells 1995;13:32—37.6. Salvarini C., Casali B., Salvo D. et al. The role of interleukine-1, erythropoietin and red cell bound immunoglobulins in the anemia of rheumatoid arthritis. Clin Exp Rheumatol 2000;9:2414—6.Salvarini C., Casali B., Salvo D. et al. The role of interleukine-1, erythropoietin and red cell bound immunoglobulins in the anemia of rheumatoid arthritis. Clin Exp Rheumatol 2000;9:2414—6.7. Canaparo R., Casale F., Muntoni E. et al. Plasma erythropoietin concentrations in patients receiving intensive platinum or nonplatinum chemotherapy. Br J Clin Pharmacol 2000;50:146—53.Canaparo R., Casale F., Muntoni E. et al. Plasma erythropoietin concentrations in patients receiving intensive platinum or nonplatinum chemotherapy. Br J Clin Pharmacol 2000;50:146—53.8. Николаев А.Ю., Козловская Л.В. Эритропоэтин: применение на ранней и диализной стадиях хронической почечной недостаточности. Consilium Medicum, Нефрология 2001; 3(7).Николаев А.Ю., Козловская Л.В. Эритропоэтин: применение на ранней и диализной стадиях хронической почечной недостаточности. Consilium Medicum, Нефрология 2001; 3(7).9. Бредер В.В., Горбунова В.А., Бесова Н.С. Анемия при злокачественных опухолях. Совр онкол 2002;4(3).Бредер В.В., Горбунова В.А., Бесова Н.С. Анемия при злокачественных опухолях. Совр онкол 2002;4(3).10. Бредер В.В., Бесова Н.С., Горбунова В.А. Анемия при химиотерапии злокачественных опухолей: эффективность Эпрекса® (Эпоэтин альфа), Фарматека, Онкология 2006;18(95).Бредер В.В., Бесова Н.С., Горбунова В.А. Анемия при химиотерапии злокачественных опухолей: эффективность Эпрекса® (Эпоэтин альфа), Фарматека, Онкология 2006;18(95).11. Harrison L., Blackwell K. Hypoxia and anemia: factors in decreased sensitivity to radiation therapy and chemotherapy. Oncologist 2004;9:31—40.Harrison L., Blackwell K. Hypoxia and anemia: factors in decreased sensitivity to radiation therapy and chemotherapy. Oncologist 2004;9:31—40.12. Motzer R.J., Bacik J., Schwartz L.H. et al. Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol 2004;22(3): 454—63.Motzer R.J., Bacik J., Schwartz L.H. et al. Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol 2004;22(3): 454—63.13. Sengelov L., Kamby C., Schou G., von der Maase H. Prognostic factors and significance of chemotherapy in patients with recurrent or metastatic transitional cell cancer of the urinary tract. Cancer 1994;74(1):123—33.Sengelov L., Kamby C., Schou G., von der Maase H. Prognostic factors and significance of chemotherapy in patients with recurrent or metastatic transitional cell cancer of the urinary tract. Cancer 1994;74(1):123—33.14. Littlewood T.J., Bajetta E., Nortier W.R. et al. Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: Results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 2001;19:2865—74.Littlewood T.J., Bajetta E., Nortier W.R. et al. Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: Results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 2001;19:2865—74.15. Bland L.B., Tangen C.M., Thompson I.M. et al. Prognostic value of anemia in untreated metastatic prostate cancer: A multivariate analysis of SWOG 8894. ASCO 2004; аbstr 4574.Bland L.B., Tangen C.M., Thompson I.M. et al. Prognostic value of anemia in untreated metastatic prostate cancer: A multivariate analysis of SWOG 8894. ASCO 2004; аbstr 4574.16. Rizzo D., Lichtin A., Woolf S. et al. Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology. J Clin Oncol 2002;20(19):4083—107.Rizzo D., Lichtin A., Woolf S. et al. Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology. J Clin Oncol 2002;20(19):4083—107.17. Fisher J.W. Erythropoietin: physiology and pharmacology update. Exp Biol Med 2003;228:1—14.Fisher J.W. Erythropoietin: physiology and pharmacology update. Exp Biol Med 2003;228:1—14.18. Hardee M.E., Arcasoy M.O., Blackwell K.L. et al. Erythropoietin biology in cancer. Clin Cancer Res 2006;12:332—9.Hardee M.E., Arcasoy M.O., Blackwell K.L. et al. Erythropoietin biology in cancer. Clin Cancer Res 2006;12:332—9.19. Engert A. Recombinant human erythropoietin in oncology: current status and further developments. Ann Oncol 2005;16(10):1584—95.Engert A. Recombinant human erythropoietin in oncology: current status and further developments. Ann Oncol 2005;16(10):1584—95.20. Cersosimo R.J., Epoetin alfa versus darbepoetin alfa in chemotherapy-related anemia. Ann Pharmacother 2005;40(1):58—65.Cersosimo R.J., Epoetin alfa versus darbepoetin alfa in chemotherapy-related anemia. Ann Pharmacother 2005;40(1):58—65.21. European best practice guidelines for the management of anaemia in patrients with chronic renal failure. Nephrol Dial Transplant 1999;14 (Suppl 5):1—50.European best practice guidelines for the management of anaemia in patrients with chronic renal failure. Nephrol Dial Transplant 1999;14 (Suppl 5):1—50.22. Seidenfeld J., Piper M., Flamm C. et al. Epoetin treatment of anemia associated with cancer therapy: a systematic review and meta-analysis of controlled clinical trials. J Natl Cancer Inst 2001; 93(16):1204—14.Seidenfeld J., Piper M., Flamm C. et al. Epoetin treatment of anemia associated with cancer therapy: a systematic review and meta-analysis of controlled clinical trials. J Natl Cancer Inst 2001; 93(16):1204—14.23. Quirt I., Robeson C., Lau C.Y. et al.; the Canadian Eprex Oncology Study Group. Epoetin alfa therapy increases hemoglobin levels and improves quality of life in patients with cancer-related anemia who are not receiving chemotherapy and patients with anemia who are receiving chemotherapy. J Clin Oncol 2001;19(21):4126—34.Quirt I., Robeson C., Lau C.Y. et al.; the Canadian Eprex Oncology Study Group. Epoetin alfa therapy increases hemoglobin levels and improves quality of life in patients with cancer-related anemia who are not receiving chemotherapy and patients with anemia who are receiving chemotherapy. J Clin Oncol 2001;19(21):4126—34.24. Glaspy J., Bukowski R., Steinberg D. et al. Impact of therapy with epoetin alfa on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. J Clin Oncol 1997;15:1218—34.Glaspy J., Bukowski R., Steinberg D. et al. Impact of therapy with epoetin alfa on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. J Clin Oncol 1997;15:1218—34.25. Demetri G.D., Kris M., Wade J. et al. Quality-of-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: results from a prospective community oncology study. Procrit Study Group. J Clin Oncol 1998;16:3412—25.Demetri G.D., Kris M., Wade J. et al. Quality-of-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: results from a prospective community oncology study. Procrit Study Group. J Clin Oncol 1998;16:3412—25.26. Gabrilove J.L., Cleeland C.S., Livingston R.B. et al. Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: improvements in hemoglobin and quality of life are similar to three-times-weekly dosing. J Clin Oncol 2001;19:2875—82.Gabrilove J.L., Cleeland C.S., Livingston R.B. et al. Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: improvements in hemoglobin and quality of life are similar to three-times-weekly dosing. J Clin Oncol 2001;19:2875—82.27. Witzig T.E., Silberstein P.T., Loprinzi C.L. et al. Phase III, randomized, double-blind study of epoetin alfa compared with placebo in anemic patients receiving chemotherapy. J Clin Oncol 2005;23(12): 2606—17.Witzig T.E., Silberstein P.T., Loprinzi C.L. et al. Phase III, randomized, double-blind study of epoetin alfa compared with placebo in anemic patients receiving chemotherapy. J Clin Oncol 2005;23(12): 2606—17.28. Bohlius J., Wilson J., Seidenfeld J. et al. Recombinant human erythropoietins and cancer patients: updated metaanalysis of 57 studies including 9353 patients. J Natl Cancer Inst 2006;98(10):708—14.Bohlius J., Wilson J., Seidenfeld J. et al. Recombinant human erythropoietins and cancer patients: updated metaanalysis of 57 studies including 9353 patients. J Natl Cancer Inst 2006;98(10):708—14.29. Demetri G.D., Kris M., Wade J. et al. for the Procrit Study Group. Qualityof-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: Results from a prospective community oncology study. J Clin Oncol 1998;16:3412—25.Demetri G.D., Kris M., Wade J. et al. for the Procrit Study Group. Qualityof-life benefit in chemotherapy patients treated with epoetin alfa is independent of disease response or tumor type: Results from a prospective community oncology study. J Clin Oncol 1998;16:3412—25.30. Glaspy J., Bukowski R., Steinberg D. et al. Impact of therapy with epoetin alpha on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. J Clin Oncol 1997;15:1218—34.Glaspy J., Bukowski R., Steinberg D. et al. Impact of therapy with epoetin alpha on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. J Clin Oncol 1997;15:1218—34.31. Gorbounova V., Breder V., Besova N. Eprex in the treatment of cisplatininduced anemia in cancer patient. 11th International Congress on Anti-Cancer Treatment; Paris, February 6-9, 2001. p. 274 (abstr AB35).Gorbounova V., Breder V., Besova N. Eprex in the treatment of cisplatininduced anemia in cancer patient. 11th International Congress on Anti-Cancer Treatment; Paris, February 6-9, 2001. p. 274 (abstr AB35).32. Rosenblum N., Levine M.A., Handler T., Lepor H. Impact of preoperative intake epoetin alpha in patients who have transferred radical retropubical prostatectomy. J Urol 2000;193:829—33.Rosenblum N., Levine M.A., Handler T., Lepor H. Impact of preoperative intake epoetin alpha in patients who have transferred radical retropubical prostatectomy. J Urol 2000;193:829—33.33. Gabrilove J.L., Cleeland C.S., Livingston R.B. et al. Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: improvements in hemoglobin and quality of life are similar to three-times-weekly dosing. J Clin Oncol 2001;19:2875—82.Gabrilove J.L., Cleeland C.S., Livingston R.B. et al. Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: improvements in hemoglobin and quality of life are similar to three-times-weekly dosing. J Clin Oncol 2001;19:2875—82.34. Crawford J., Cella D., Cleeland C.S. et al. Relationship between changes in haemoglobin level and quality of life during chemotherapy in anaemic cancer patients receiving epoetin alpha therapy. Cancer 2002;95: 888—95.Crawford J., Cella D., Cleeland C.S. et al. Relationship between changes in haemoglobin level and quality of life during chemotherapy in anaemic cancer patients receiving epoetin alpha therapy. Cancer 2002;95: 888—95.