Influence of TNF-alpha on the efficacy of anemia correction in patients with lymphoproliferative disorders

Abstract

In this article mechanisms of anaemia development in patients with lymphatic tissue malignant diseases are presented. Therapy efficacy of erythropoiesis-stimulating agents (EPO) in patients with lymphoproliferative disorders and anaemia (n = 21) is studied. Study group included patients with a chronic lymphoid leukemia (n = 5), indolent lymphomas (n = 7) and multiple myeloma (n = 9). Patients were 49–80 years of age (63.6 ± 8.2 years). The positive response to EPO therapy was considered if hemoglobin level increased on 20 g/l or its rising to 120 g/l. With given therapy hemoglobin level was increased from 86.8 ± 18.5 g/l to 111.4 ± 26.5 g/l (p < 0.001). EPO therapy efficacy was 61.9 % for total group of patients. Importance of TNF-alpha detection as the prognosis factor of EPO therapy efficacy was studied. Patients with low level of TNF-alpha (less than 15 pg/ml) achieved the positive response in 92.9 %, with a high level of TNF-alpha (more than 15 pg/ml) – the positive response was not observed. Inversely proportional correlation between initial TNF-alpha level and therapy response has been established (r = -0.487; p < 0.03; n = 21). Thus, detection of TNF-alpha level in patients with lymphoproliferative disorders before EPO therapy allows to predict therapy response with high degree of significance.

Keywords

• anemia
• chronic lymphocytic leukemia
• multiple myeloma
• lymphoma
• recombinant erythropoietin
• epoietin alpha
• eralfon
• tnf-alpha