Document Detail


Cisplatin-associated anemia: an erythropoietin deficiency syndrome.
MedLine Citation:
PMID:  7706473     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cisplatin-based therapy results in a cumulative anemia that is disproportionate to the effects on other blood cells. The severity of this treatment-induced anemia and the resultant transfusion requirement in cancer patients correlate with cisplatin-induced renal tubular dysfunction. Observed/expected serum erythropoietin (EPO) ratios decline with progressive cisplatin therapy and are proportionate to the degree of renal dysfunction. Recovery from anemia and of observed/expected serum EPO ratios in patients occurs after cessation of cisplatin therapy, along with restoration of renal tubular function. Creatinine clearance, however, remains permanently depressed. Cisplatin-treated rats develop progressive renal dysfunction and anemia that persists for many weeks, without effects on white blood cell counts. The anemia is also associated with a lack of expected EPO and reticulocyte response. With EPO administration, cisplatin-treated rats exhibit a greater reticulocyte response and hematocrit increment then non-cisplatin-treated rats given EPO, indicating minimal erythroid precursor cell damage from cisplatin. These results indicate the primary etiology of cisplatin-associated anemia is a transient, but persisting EPO deficiency state resulting from cisplatin-induced renal tubular damage, which can be prevented or treated by hormone (EPO) replacement.
Authors:
P A Wood; W J Hrushesky
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of clinical investigation     Volume:  95     ISSN:  0021-9738     ISO Abbreviation:  J. Clin. Invest.     Publication Date:  1995 Apr 
Date Detail:
Created Date:  1995-05-09     Completed Date:  1995-05-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7802877     Medline TA:  J Clin Invest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1650-9     Citation Subset:  AIM; IM    
Affiliation:
Stratton Veterans Affairs Medical Center, Albany, New York 12208, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anemia / chemically induced*
Animals
Blood Cell Count
Bone Marrow / drug effects
Cisplatin / adverse effects*,  toxicity
Creatinine / pharmacokinetics
Doxorubicin / adverse effects
Erythropoietin / blood,  deficiency*
Female
Follow-Up Studies
Hematocrit
Humans
Kidney Function Tests
Kidney Tubules / drug effects*,  metabolism
Magnesium / pharmacokinetics
Male
Middle Aged
Multivariate Analysis
Ovarian Neoplasms / therapy
Phenylhydrazines / pharmacology
Rats
Syndrome
Urinary Bladder Neoplasms / therapy
Grant Support
ID/Acronym/Agency:
5M-01RR00400/RR/NCRR NIH HHS; R01 CA-31635/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Phenylhydrazines; 11096-26-7/Erythropoietin; 114-83-0/N(1)-acetylphenylhydrazine; 15663-27-1/Cisplatin; 23214-92-8/Doxorubicin; 60-27-5/Creatinine; 7439-95-4/Magnesium
Comments/Corrections

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