You are here

Kemoterapi alan lösemili hastalarda serum eritropoietin düzeyleri

Serum Erythropoietin Levels in Leukemia Patients Receiving Cytostatic Treatment

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Anemia is the major stimulus for erythropoietin (Epo) secretion. Various studies have reported increases in Epo levels following chemotherapy. The mechanism has not yet been clarified. In this study, we evaluated serum Epo levels before, during (7 and 14 days), and after (day 25) chemotherapy in patients with acute myeloblastic leukemia (n=13) and lymphoblastic leukemia (n=4). As control group, 12 healthy subjects were evaluated. Epo levels were high in untreated leukemia patients compared to controls and continued to increase following chemotherapy. There was no significant difference in post-treatment values of Epo as compared with pre-treatment levels. In patients with pre-treatment values of Hb £ 9 g/dl, Epo levels were inversely correlated with Hb (r: 0.552, p< 0.05). This correlation disappeared during and following treatment. There was no correlation between Epo and hematological or biochemical parameters. Therefore, elevated levels of Epo regardless of anemia may be due to a response to tissue hypoxia or increased synthesis of Epo in liver or bone marrow. [Journal of Turgut Özal Medical Center 1997;4(1):50-52]
Abstract (Original Language): 
Eritropoietin (Epo) sekresyonimda anemi major situmulusdur. Çeşitli çalışmalarda kemoterapiyi takiben Epo düzeylerinin arttığı bildirilmiştir. Bu artışın nedeni henüz tam olarak açıklanamamıştır. Bu çalışmada 17 akut lösemili hastada (13 akut myeloblastik, 4 akut lenfoblastik) kemoterapi öncesi, sırası ve sonrası serum Epo düzeyleri ölçüldü. Kontrol grubu olarak 12 sağlıklı kişi çalışmaya alındı. Tedavi öncesi Epo seviyeleri lösemili hastalarda kontrol grubuna göre yüksek olup, bu yükseklik tedavi sonrası devam etti. Tedavi öncesi ile tedavi sonrası değerler arasında anlamlı bir fark yoktu. Tedavi öncesi Hb ve Epo düzeyleri arasında Hb £ 9 g/dl olan grupta zıt ilişki vardı (r: -52, p<0,05). Bu ilişki tedavi sırası ve sonrasında kayboldu. Epo ile diğer hematolojik ve biokimyasal parametreler arasında ilişki bulunamadı. Anemi olmadan Epo'nun artışında, kemoterapiye bağlı doku hipoksisi veya karaciğer ve kemik iliği orijinli Epo sentezi gibi diğer nedenlerin rolü olabilir. [Turgut Özal Tıp Merkezi Dergisi 1997;4(l):50-52]
50-52

REFERENCES

References: 

1. Goldwasser E. Erythropoietin and red cell differentiation. In: Control of Cellular Differentiation and Development.Cunningham D, Goldwasser E, Watson J, Fox CF (Eds). New York: Alan R Liss, 1981: 487-502.
2. Koury ST, Bondurant MC, Koury MJ. Localization of erythropoietin synthesizing cells in murine kidney by in situ
hybrization. Blood 1988; 71: 524-7.
3. Bauer C. Physiologic determinants of erythropoietin production. Seminars in Hematology 1991;28(Supl 3):9-13.
4. Jelkmann W. Renal erythropoietin: Properties and production. Rev Physiol Biochem Pharmacol 1986; 104: 139-215.
5. Erslev AJ, Wilson J, Caro J. Erythropoietin titers in anemic,
nonuremic patients. J Lab Clin Med 1987; 109: 429-33.
6. Schrezenmeier H, Noe G, Raghavachar A, Rich IN, Heimpel H, Kubanek B. Serum erythropoietin and transferrin receptor levels in aplastic anemia. Br J Haematol 1994; 88:
286-94.
7. Vannucchi AM, Grossi A, Bosi A, et al. Impaired erythropoietin production in mice treated with cyclosporin A. Blood 1991; 78: 1615-8.
8. Piroso E, Erslev AJ, Caro J. Inappropriate increase in erythropoietin titers during chemotherapy. Am J Hematol
1989; 32: 248-54.
9. Birgegard G, Wide L, Simonson B. Marked erythropoietin increase before fall in Hb after treatment with cytostatic drugs suggests mechanism other than anaemia for
stimulation. Br J Haematol 1989; 72: 462-6.
10. Helebostad M, Marstrander J, Slordahl SH, et al. Serum immunoreactive erythropoietin in children with acute leukemia at various stages of disease- and the effects of
treatment. Eur J Haematol 1990; 44: 159-64.
11. Johannsen H, Jelkmann W, Wiedemann G, Otte M, Wagner T. Erythropoietin/haemoglobin relationship in leukemia and ulcerative colitis. Eur J Haematol 1989; 43: 201-6.
12. Jelkmann W, Wiedemann G. High serum immunoreactive erythropoietin in leukaemic patients with bone marrow insufficiency of erythropoiesis. Eur J Haematol 1990;44:
271-2.
13. Schapira L, Antin JH, Ransil BJ, et al. Serum erythropoietin levels in patients receiving intensive chemotherapy and
radiotherapy. Blood 1990; 76: 2354-9.
14. Bowen DT, Janowska-Wieczorek A. Serum erythropoietin following cytostatic therapy. Br J Haematol 1990;74:372-3.
15. Grace RJ, Kendall RG, Chapman C, Hartley AE, Barnard DL, Norfolk DR. Changes in serum erythropoietin levels during allogeneic bone marrow transplantation. Eur J
Haematol 1991; 47: 81-5.

Thank you for copying data from http://www.arastirmax.com