• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1081-1091
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• 2012

Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematologic neoplasms characterized by morphologic dysplasia, aberrant hematopoiesis and peripheral blood refractory cytopenias. MDS is recognized to be associated with an increased risk of symptomatic anemia, infectious complications and bleeding diathesis, as well as a risk of progression to acute myeloid leukemia, particularly in patients with a high IPSS score. The advent of use of hematopoietic growth factors such as granulocyte colony-stimulating factor (G-CSF) and recombinant erythropoietin (EPO) has improved symptoms in MDS patients in addition to some data that suggest there might be an improvement in survival. G-CSF is an effective therapeutic option in MDS patients, and it should be considered for the management of refractory symptomatic cytopenias. G-CSF and EPO in combination can improve outcomes in appropriate MDS patients such as those with lower-risk MDS and refractory anemia with ring sideroblasts (RARS). This article reviews use of growth factors for lower-risk MDS patients, and examines the data for G-CSF, EPO and thrombopietic growth factors (TPO) that are available or being developed as therapeutic modalities for this challenging disease.

• The Korean journal of internal medicine
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• 제39권3호
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• pp.488-500
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• 2024

Background/Aims: Roxadustat, an oral medication for treating renal anemia, is a hypoxia-inducible factor prolyl hydroxylase inhibitor used for regulating iron metabolism and promoting erythropoiesis. To investigate the efficacy and safety of roxadustat in patients undergoing peritoneal dialysis (PD) with erythropoietin hyporesponsiveness. Methods: Single-center, retrospective study, 81 PD patients (with erythropoietin hyporesponsiveness) were divided into the roxadustat group (n = 61) and erythropoiesis-stimulating agents (ESAs) group (n = 20). Hemoglobin (Hb), total cholesterol, intact parathyroid hormone (iPTH), brain natriuretic peptide (BNP), related indicators of cardiac function and high-sensitivity C-reactive protein (hs-CRP) were collected. Additionally, adverse events were also recorded. The follow-up period was 16 weeks. Results: The two groups exhibited similar baseline demographic and clinical characteristics. At baseline, the roxadustat group had a mean Hb level of 89.8 ± 18.9 g/L, while the ESAs group had a mean Hb level of 95.2 ± 16.0 g/L. By week 16, the Hb levels had increased to 118 ± 19.8 g/L (p < 0.05) in the roxadustat group and 101 ± 19.3 g/L (p > 0.05) in the ESAs group. The efficacy of roxadustat in improving anemia was not influenced by baseline levels of hs-CRP and iPTH. Cholesterol was decreased in the roxadustat group without statin use. An increase in left ventricular ejection fraction and stabilization of BNP were observed in the roxadustat group. Conclusions: For PD patients with erythropoietin hyporesponsiveness, roxadustat can significantly improve renal anemia. The efficacy of roxadustat in improving renal anemia was not affected by baseline levels of hs-CRP0 and iPTH.

• Clinical and Experimental Pediatrics
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• 제52권10호
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• pp.1061-1068
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• 2009

만성 신질환 환아들의 치료는 신대체 요법과 더불어 적절한 식이 요법, 수분, 전해질 및 산-염기의 관리, 신장 골형성 장애의 예방 및 치료, 빈혈과 고혈압, 성장 지연의 치료 등으로 이루어진다. 식이 요법은 환아들의 성장이 충분히 이루어질 수 있도록 탄수화물, 지방, 단백질 및 열량의 공급이 적절하게 이루어져야 한다. 수분, 전해질 및 산-염기의 상태를 확인하고 적절하게 관리해야 한다. 혈청 칼슘, 인, 부갑상선 호르몬 농도가 사구체 여과율에 따른 적절한 목표치 안에서 유지될 수 있도록 인 결합 제제와 비타민 D 제제를 투여하여 신장 골형성 장애를 예방하여야 한다. 적혈구 생산 촉진제와 철분 제제를 투여하여 혈색소 값을 11-12 g/dl로 유지하여야 한다. 수분 및 염분의 균형과 적절한 항고혈압제의 투여로 고혈압을 조절해야 한다. 사람 재조합 성장 호르몬을 투여하여 최종 성인 키를 호전시키도록 한다.