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Erythropoiesis stimulating agents, thrombosis and cancer.

机译:促红细胞生成剂,血栓形成和癌症。

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摘要

Venous thromboembolism (VTE) is common in cancer and is associated with both morbidity and mortality. Erythropoiesis stimulating agents (ESAs) were originally developed to correct anemia. Recent trials in cancer patients however, raise concerns over both increased VTE rates and the possibility of worse tumour outcomes and increased mortality with ESA use. The most common reason offered for explaining the possible negative impact of ESAs on cancer outcomes has been the stimulation of erythropoietin receptors on tumour cells. Despite an extensive literature, it is unlikely that most practicing appreciate the intricate relationship and interaction between the coagulation pathways, angiogenesis and tumour progression and ESA effects. This paper will review these connections and interactions and examine the hypothesis that other mechanisms may underlie the possible negative impact of ESAs on cancer outcomes.
机译:静脉血栓栓塞症(VTE)在癌症中很常见,并且与发病率和死亡率均相关。红细胞生成刺激剂(ESA)最初是为了纠正贫血而开发的。然而,最近在癌症患者中进行的试验引起了人们对VTE率升高,肿瘤结局恶化和使用ESA死亡率增加的可能性的担忧。解释ESA对癌症结局可能产生的负面影响的最常见原因是刺激促红细胞生成素受体对肿瘤细胞的刺激。尽管有大量的文献,大多数实践者不太可能意识到凝血途径,血管生成,肿瘤进展和ESA效应之间的复杂关系和相互作用。本文将回顾这些联系和相互作用,并检验以下假设:其他机制可能是ESA对癌症结果可能产生负面影响的基础。

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