Javad Yaghmoorian Khojini,1Fatemeh Mohammad-Rafiei,2Ali Osmay Gure,3,*
1. Master student of medical biotechnology/ Department of Medical Biotechnology/ School of Medicine/ Shahid Sadoughi University of Medical Sciences/ Yazd/ Iran 2. Master student of medical biotechnology/ Department of Medical Biotechnology/ School of Medicine/ Shahid Sadoughi University of Medical Sciences/ Yazd/ Iran 3. MD, PhD Chair, Department of Medical Biology Acibadem University Istanbul, Turkey
Introduction: Patients with developed cancer often undergo clinically significant anemia that occurs through myelosuppressive chemotherapy. In more detail, severe anemia, defined as a hemoglobin level less than 8g/dL, is usually treated, whereas on another side mild-to-moderate anemia (hemoglobin level of 8–11 g/dL) is left untreated in most patients undergoing treatment with chemotherapy and radiation therapy. Another notable point is that the serum concentration of erythropoietin (EPO) is lower in cancer patients than in patients with iron deficiency, which suggests that the anemia observed in cancer patients is at least partially due to EPO deficiency. In the past, blood transfusion was the only treatment option for severe cancer-related anemia and the fastest means to alleviate symptoms associated with anemia, however, there are short-term and long-term effects associated with this treatment like the transmission of infectious agents, transfusion reactions, etc. which have prompted oncologists to develop more safe and efficient treatments like recombinant human erythropoietin (rHuEPO) therapy. Until now, various scholars working on investigating the efficiency of this therapy and also shedding light on different aspects of its utilization in the patient's life level improvement.
Methods: This study has been performed by searching various texts, authoritative scientific articles, and several keywords such as anemia, cancer, erythropoietin, rHuEPO and so on to find all relevant publications on the role of recombinant human erythropoietin in cancer disease.
Results: According to the findings, more than half of cancer patients have a low serum level of erythropoietin. The introduction of recombinant human erythropoietin (RHuEPO) has revolutionized the treatment process for patients with anemia of chronic renal disease. The initial results demonstrated that RHuEPO could restore the packed cell volume, decrease the necessity of regular blood transfusion in patients, and improve overall well-being. The results of these trials were so impressive that RHuEPO was granted a license as a therapeutic agent in 1988 for patients with anemia of chronic renal failure, only three years after its discovery. Other studies have demonstrated that recombinant human erythropoietin (rHuEPO) has been used safely and effectively to treat anemia, it is shown that RHuEPO therapy corrects 50% of cancer anemia in general. The results of rHuEPO therapy in chronic anemia of cancer are far more than laboratory values. The quality of life after treatment with recombinant human erythropoietin (rHuEPO) often have been reported in patients with end-stage cancer disease. Different studies present that the patients treated with erythropoietin had a statistically significantly lower risk of blood transfusion and, on average, received statistically significantly fewer blood transfusions, and cancer patients treated with erythropoietin had an increased hematologic response compared with untreated patients. In general, RHuEPO therapy improves both treatment outcomes and the survival of cancer patients.
Conclusion: The above results suggest that r-HuEPO may be a proper agent to alleviate the consequences of the anemia that is usually found in association with advanced cancer. The rHuEPO therapy also enables the patients with response to lead a physically and socially more active life with less anxiety, brighter moods, and an increased general feeling of well-being.
Keywords: rHuEPO, Erythropoietin, Cancer, Anemia, Recombinant Protein