В статье представлена лекция, в которой подробно рассмотрены основные патогенетические механизмы развития и особенности течения анемического синдрома у больных лимфопролиферативными заболеваниями (ЛПЗ). Представлена классификация хронической анемии и методы ее лечения. Сделан акцент на коррекции анемии с помощью переливаний эритроцитной массы: освещены показания для трансфузий эритроцитов, оценка их эффективности, а также приведены посттрансфузионные осложнения. Продемонстрирован случай из практики успешного патогенетического лечения больной неходжкинской лимфомой с синдромом Эванса. В лекции также подробно рассмотрен метод терапии анемии у пациентов с ЛПЗ с помощью эритропоэзстимулирующих препаратов: представлены характеристика разных препаратов, алгоритмы их назначения, показания к применению, оценка эффективности и возможные побочные эффекты. Приведены факторы прогноза эффективности эпоэтинов в зависимости от ряда лабораторных тестов.
The paper presents a lecture that considers the major pathogenetic mechanisms of development and the specific features of the course of anemia syndrome in patients with lymphoproliferative diseases (LPD). It gives a classification of chronic anemia and methods of its treatment. Emphasis is placed on the correction of anemia by packed red blood cell transfusion; indications for the latter, its efficiency, and posttransfusion complications are outlined. A case of successful pathogenetic treatment is demonstrated in a female patient with non-Hodgkin’s lymphoma concurrent with Evans’ syndrome. The lecture also details anemia therapy with erythropoiesis-stimulating drugs in patients with LPD and gives the characteristics of different medications, algorithms and indications for their use, efficacy evaluation, and possible side effects. Prognostic factors for the efficacy of epoietins are given in relation to a number of laboratory tests.
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Авторы
Н.А.Романенко
ФГБУ Российский научно-исследовательский институт гематологии и трансфузиологии Федерального медико-биологического агентства, Санкт-Петербург