Tavukçu Fatma ERGİN, Gülnur TOKUÇ, Sedat ÖKTEM, Perran BORAN, Özlem KETENCİ

Solid tümörlü çocuklarda eritropoetin tedavisi

Amaç: Solid tümörlü çocuklarda eritropoetin tedavisinin etkinlik ve güvenilirliğini ve eritrosit transfüzyonu ihtiyacını azaltıp azaltmadığını tespit etmek. Gereç ve Yöntem: Haziran 2002-Temmuz 2003 tarihleri arasında 26 solid tümörlü hasta çalışmaya dahil edildi. Erkek/kız oranı 17/9, ortalama yaş 6.8±3.4 yıl (15 ay-14 yıl) idi. On bir hasta rekombinan insan eritropoetini ile 150 IU/kg/g, haftada 3 kez, subkutan olarak 8 hafta tedavi edildi. 15 hasta kontrol grubundaydı. Tedavi tamamlandıktan sonra tüm hastalar hemoglobin konsantrasyonu, eritrosit suspansiyonu transfüzyonu ihtiyacı ve yan etkiler açısından incelendi. Sonuçlar: Tedavi öncesi ve tedavinin sonunda ortalama hemoglobin düzeyi eritropoetin grubunda 9.7±0.8 g/dL ve 11.4±1.3 g/dL, kontrol grubunda ise 10.5±1.1 g/dL ve 10±2 g/dL idi. Eritropoetin grubunda sadece 1 kez transfüzyon ihtiyacı olmasına karşın kontrol grubunda 30 kez transfüzyon ihtiyacı oldu. Eritropoetin 1 hastada kan basıncının yükselmesi ve konvülziyona neden oldu. Kan basıncı yüksekliği ilacın kesilmesinden birkaç gün sonra düzeldi. Sonuç: Eritropoetin tedavisi solid tümörlü çocuklarda etkili ve güvenli gibi gözükmektedir. Bu hastalarda eritrosit transfüzyonu ihtiyacını azaltmaktadır.

Anahtar Kelimeler:

Neoplazmlar, Anemi, Çocuk, Eritropoietin

Erythropoietin treatment in children with solid tumors

Objective: The efficacy and safety of recombinant human erythropoietin (rHuEPO) treatment and red blood cell transfusion requirements were examined in children with solid tumors. Material and Methods: Twenty-six patients with solid tumors between January 2002 to July 2003 were included in this study. The male/female ratio was 17/9, and mean age 6.8±3.4 years (15 months-14 years). Eleven patients were treated with rHuEPO 150 IU/kg/d, 3 times a week, subcutaneously for 8 weeks. There were 15 patients in the control group. At the end of rHuEPO treatment, all patients were examined in terms of hemoglobin concentration, RBC transfusion requirements and side effects. Results: The mean hemoglobin levels before and at the end of the study were 9.7±0.8 g/dL and 11.4±1.3 g/dL in the erythropoietin group and 10.5±1.1 g/dL and 10±2 g/dL in the control group, respectively. Only one case in the erythropoietin group needed red blood cell transfusion, whereas 30 transfusions were needed in the control group. rHuEPO caused high blood pressure and seizure in only 1 patient. High blood pressure resolved after cessation of rHuEPO treatment for a few days. Conclusion: rHuEPO treatment appears to be effective and safe in children with solid tumors. It decreases transfusion requirements in these patients.

Keywords:

Neoplasms, Anemia, Child, Erythropoietin,

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