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Efficacy of Darbepoetin alfa in Anemia Developed during Chemotherapy for Lung Cancer

폐암 환자에서 항암화학치료 중 발생한 빈혈에 대한 Darbepoetin alfa의 효과

  • Ban, Hee-Jung (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Chi, Su-Young (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Park, Cheol-Kyu (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Eun-Young (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Yoon-Hee (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Kyu-Sik (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Ju, Jin-Young (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kwon, Yong-Soo (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Oh, In-Jae (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Yu-Il (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lim, Sung-Chul (Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Young-Chul (Department of Internal Medicine, Chonnam National University Medical School)
  • 반희정 (전남대학교 의과대학 내과학교실) ;
  • 지수영 (전남대학교 의과대학 내과학교실) ;
  • 박철규 (전남대학교 의과대학 내과학교실) ;
  • 김은영 (전남대학교 의과대학 내과학교실) ;
  • 김윤희 (전남대학교 의과대학 내과학교실) ;
  • 김규식 (전남대학교 의과대학 내과학교실) ;
  • 주진영 (전남대학교 의과대학 내과학교실) ;
  • 권용수 (전남대학교 의과대학 내과학교실) ;
  • 오인재 (전남대학교 의과대학 내과학교실) ;
  • 김유일 (전남대학교 의과대학 내과학교실) ;
  • 임성철 (전남대학교 의과대학 내과학교실) ;
  • 김영철 (전남대학교 의과대학 내과학교실)
  • Received : 2008.10.05
  • Accepted : 2009.02.03
  • Published : 2009.02.28

Abstract

Background: Anemia is quite common in lung cancer patients and known to decrease the quality of life. Darbepoetin alfa is an erythropoiesis-stimulating protein approved for administration to cancer patients. This study examined the efficacy and safety of darbepoetin alfa in lung cancer patients with a hemoglobin concentration <10 g/dl during chemotherapy. Methods: Lung cancer patients (n=178) received darbepoetin alfa at doses of 1.91 ${\mu}g/kg$ per week until the hemoglobin concentration increased to >10 g/dl. The efficacy and safety were measured by comparing the hemoglobin concentration and assessing the adverse events. Results: After chemotherapy, the hemoglobin concentration decreased to 9.03${\pm}$0.64 g/dl. With the darbepoetin alfa treatment, the hemoglobin concentration increased to 10.09${\pm}$1.17 g/dl after 4 weeks reaching a peak hemoglobin concentration of 10.45${\pm}$1.18 g/dl. The changes in hemoglobin after 4 and 8 weeks with treatment were 1.08${\pm}$1.24 g/dl and 1.38${\pm}$1.59 g/dl (p<0.01). At least a 1 g/dl or more increase in hemoglobin was observed in 62.4% of patients. There were no serious adverse effects except for some mild reactions. Conclusion: Darbepoetin alfa administered to lung cancer patients appears to be an effective, well-tolerated treatment for chemotherapy induced anemia.

연구배경: 빈혈은 폐암 환자의 항암 치료중 발생하여 삶의 질을 떨어뜨리는 원인이 된다. 최근 사용 되는 darbepoetin alfa는 적혈구 생성 촉진 인자로 사용되고 있어 이의 효과와 부작용을 알아보고자 하였다. 방 법: 2004년 9월부터 2007년 3월까지 화순전남대학교 병원을 내원한 환자 중에서 소세포 혹은 비소세포 폐암을 진단받고 항암 화학 치료를 적어도 1개월 이상 받은 환자들 중에서 혈색소 수치 10 g/dl 미만의 빈혈이 발생한 환자들 중 darbepoetin alfa를 투여 받은 환자를 대상으로 후향적으로 분석하였다. 결 과: 항암 화학 치료 후 혈색소는 9.03${\pm}$0.64 g/dl로 감소하였고, darbepoetin alfa를 처치 후 혈색소 1 g/dl 이상의 증가를 보였던 환자는 62.4%였으며 최고치 10.45${\pm}$1.18 g/dl, 4주째 10.09${\pm}$1.17 g/dl로 관찰되었다. 경증 부작용이 일부에서 관찰되었나 모두 호전되었다. 결 론: darbepoetin alfa는 항암 치료와 연관된 빈혈의 치료에 효과적이며 부작용이 심하지 않아 보조 치료제로 사용될 수 있겠다.

Keywords

References

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