Peran Eritropoietin pada Anemia Akibat Keganasan pada Anak

Reni Suryanty, Nelly Rosdiana, Bidasari Lubis

Sari


Anemi relatif sering terjadi pada kasus keganasan hematologi atau tumor padat, namun
penyebab anemia belum jelas diketahui. Eritropoietin merupakan suatu glikoprotein
hormon yang dapat merangsang proliferasi dan diferensiasi sel-sel progenitor darah merah.
Salah satu penanganan anemia yaitu pemberian transfusi yang mempunyai banyak risiko
diantaranya risiko transmisi infeksi, hemolitik, non- hemolitik, penumpukan besi dan
penekanan produksi eritropoietin endogen. Dipertimbangkan pemberian eritropoietin
eksogen (human recombinan erythropoietin) yang identik dengan eritropoietin endogen
pada keganasan terutama yang mendapat kemoterapi bila Hb £ 10 g/dL dengan dosis
150 U/kg BB 3x seminggu selama 4 minggu dan dosis dapat ditingkatkan hingga 300
U/kg BB dan diberikan selama 4 - 8 minggu. Diperlukan pemeriksaan secara periodik
terhadap kadar besi, TIBC, (total iron binding capacity) saturasi transferin dan feritin.
Rhu-EPO dipasaran yaitu epoetin alfa dan beta. Efek samping Rhu-EPO antara lain
hipertensi, nyeri kepala, nyeri tulang, mual, edem, lemah dan diare. Dilaporkan pada
epoetin beta relatif jarang terjadi hipertensi dan dilaporkan tentang terjadinya kasus
pure red cell aplasia pada pemberian epoetin alfa (eprex).


Kata Kunci


keganasan; anemia; eritropoietin

Teks Lengkap:

PDF

Referensi


The agency for health care research and quality (AHRQ).

Uses of epoetin for anemiaa in oncology. Evidence report/

technology assessment 2001; 30:1-13.

Christensen RD, Ohls RK,. Development of the

hematopoieric system. Dalam: Behrman RE, Kliegman

RM, Arvin Am, penyunting. Nelson textbook of pediatrics.

Edisi ke-15. Philadelphia: Saunders, 1996. h.

-82.

Firat D, Banzon J. Erythropoietic effect of plasma from

patients with advanced cancer. Cancer Res 1971;

:1353-9.

Brumariu O, Miron I, Munteanu M, Gavrilovici C. The

use of growth factors in pediatric diseases. Didapat dari:

URL: http://www.nefroped.net 2000.ro/article 002.htm

Ludwig H. Eritz E, Kotzmann H, Hocker P, Gisslinger

H, Barnas U. Erythropoetin treatment of anemiaa associated

with multiple myeloma. N Engl J Med 1990;

:1693-9.

Lubis B. Eritropoietin pada sepsis pediatrik. Disampaikan

pada Simposium Nasional Pediatri Gawat Darurat

VI, Medan, 4 Oktober, 2003.

Miller DR. Eritropoietin, hypoplastic anemiaas, and

disorders of heme synthesis, Dalam: Miller DR, Bachner

RL, Miller LP. Blood diseases of infancy and childhood.

Edisi ke – 7. St Louis: Mosby, 1995. h. 140-82.

Ganong WF. Erythropoetin. Riview of Medical Physiology.

Edisi ke 14. London: Prentice – Hall, 1989. h.

Porter JC, Leahey A, Polise K, Buning, Manno CS. Recombinant

human erythropoietin reduces the need

erythrocyte and platelet transfusion in pediatrics patient

with sarcoma: A randomized, double-blind, placebocontrolled

trial. J Pediatr, 1996; 129:656-60.

Miller CB, Platanias LC, Mills SR, Zahurak ML, Ratain

MJ, Ettinger DS. Phase I – II trial of erythropoetin in

the treatment of cisplatin – associated anemiaa. J National

Cancer Institute 1992; 84:100-3

Dainiak N, Kulkarni V, Howard D, Kalmanti M, Dewey

MC, Hoffman R. Mechanism of abnormal erythropoiesis

in malignancy. Cancer, 1983; 51:1101-6.

Permono B. Anemiaa dan eritropoitin. Disampaikan

pada Simposium Nasional Nefrologi Anak IX Hemato-

Onkologi Anak. Batu. 12-14 Desember, 2003.

Miller CB, Jones RJ, Piantodosi S, Abeloff MD, Spivak

JL. Decreased erythropoietin response in patients with

the anemiaa of cancer. N Engl J Med 1990; 322:1689-2.

Pizzo PA, Poplack DG. Erythrocyte replacement therapy.

Principles and practice of pediatric oncology. Edisi ke –

Philadelphia: Lippincott-Raven, 1997. h. 1053.

Rizzo JD, Lichtin AE, Woold SH, Seldenfeld J, Bennett

CL, Cella D, et al. Use of epoetin in patients with cancers

; evidence – based clinical practice guidelines of the

American Society of Clinical Oncology and the American

Society of Hematology. Blood 2002; 100:2303-20.

Killian A. Pediatric use of recombinat human

erythropoetin. Pediatr Pharm 2002; 8:1-5.

Drug information organized alphabetically. Epoetin alfa

recombinant. Diambil dari: URL : http://www.healhdigest.or/

dug/epoetinalfarecombinant.html.

Cheer SM, Wagstaff AJ. Epoetin beta: a review of its

clinical use in the treatment of anemiaa in patients with

cancer. Drugs 2004; 64 (3):323-46.

Exchbach JW, Kelly MR, Haley R. Treatment of the

anemiaa of progressive renal failure with recombinant

human erythropoetin. N. Engl J Med 1989; 321:158-

Means RT. Olsen NJ, Krantz SB.Treatment of the

anemiaa of rheumatoid arthritis with recombinant human

erythropoetin: Clinical and in vitro studies. Arthitis

and rheumatoid, 1989; 32:638-42.

Cazzola M. Erythropoietin therapy : need for rationality

and active survaillance. Heamatologica 2003; 06:601-3

Vaziri ND, Tang DH, Dissociation of the pressor and

erythropoetic effects of Erythropoetin. Didapat dari

URL: http:/www.uninet.edu/cid2000/ comferences/

vaziri.html.




DOI: http://dx.doi.org/10.14238/sp7.1.2005.34-8

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