低血球計數的治療 – 安健腫瘤治療中心低血球計數的治療
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What are the treatments for low blood counts?
The best treatment for low blood counts is to prevent them before they occur. This can be accomplished with the administration of blood cell growth factors. Blood cell growth factors are substances produced by the body that stimulate the cells in the bone marrow to produce more red blood cells, white blood cells, or platelets. These factors have also been produced in a laboratory and are approved by the Food and Drug Administration (FDA) for the treatment of cancer patients with low blood counts.
Low red blood cell counts: Erythropoietin is a blood cell growth factor that selectively increases production of red blood cells. Clinical trials have demonstrated that erythropoietin is safe and effective in reversing anemia in cancer patients. Erythropoietin has been proven to effectively:
Erythropoietin is FDA-approved for the treatment of anemia in patients with nonmyeloid cancers (cancers that do not involve blood cells), whose anemia is a result of chemotherapy. Treatment with erythropoietin causes a gradual increase in red blood cell production. The body uses iron in red blood cell production. Thus, supplemental iron may be required to adequately support erythropoietin-stimulated erythropoiesis. Virtually all patients receiving erythropoietin therapy will eventually require supplemental iron therapy. Currently, there are two commercially available forms of erythropoietin for use in patients, epoetin alfa (Epogen® or Procrit®) and darbepoetin alfa (Aranesp® ). Both are manufactured in the same facility in the same manner. Epogen® and Procrit® have been in use for many years. Aranesp® is a unique, longer-acting form of erythropoietin and is more convenient because it allows patients to receive fewer injections than with Epogen® or Procrit®. The most common side effects seen in clinical trials with Aranesp® were fatigue, edema, nausea, vomiting, diarrhea, fever and shortness of breath. No important differences in side effects were seen between groups treated with Aranesp® and groups treated with the existing anemia treatment, Epogen®.
Low white blood cell count: The blood cell growth factors approved by the FDA for the prevention of chemotherapy-induced neutropenia are Neupogen® (filgrastim) and Neulasta® (pegfilgrastim). Multiple clinical trials have shown that Neulasta® and Neupogen® reduce the severity and duration of low white blood cell counts associated with many kinds of chemotherapy regimens. By increasing white blood cell counts, Neupogen® has been shown to decrease a patient’s risk of fever and admission to the hospital. The drawback of Neupogen®, however, is that it must be administered daily. In two clinical trials, a single dose of Neulasta® has been proven to be as effective as an average of 11 daily injections of Neupogen® for the management of neutropenia. The most common side effect you may experience with Neulasta® is aching in the bones. If this happens, it can usually be relieved with a non-aspirin pain reliever, such as acetaminophen. It is also possible to have an allergic reaction to Neulasta®.
Low platelet count: The blood cell growth factor approved by the FDA for the prevention of low platelet count is called Neumega®. Clinical studies have shown that Neumega® prevents thrombocytopenia and decreases the need for platelet transfusions in patients at high risk for developing a low platelet count. Neumega® has been reported to cause palpitations, fluid retention and diarrhea as well as other side effects in some patients.
Transfusions: In some cases, low blood counts may be so severe that you may need to undergo a blood transfusion. Red blood cells and platelets are often transfused. Sources for transfusional blood include blood banks or your own blood that you had stored for future use before undergoing treatment. Transfusions may be associated with complications, including allergic reactions that may range from mild to life-threatening. In general, it is better to prevent low blood counts than to treat them once they occur.
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