Decreased erythropoietin response in patients with the anemia of cancer

Article Abstract:

Patients with malignant tumors are often anemic (have a reduction in the number of circulating red blood cells), but the reasons for the anemia are poorly understood. A substance that has been implicated is erythropoietin, a protein that stimulates the formation of new red blood cells in the bone marrow. Under normal circumstances, the levels of erythropoietin and hemoglobin (the molecule that carries oxygen in the blood) are maintained in an inverse linear relationship to one another; in other words, if hemoglobin levels decrease, erythropoietin levels rise. This relationship is impaired in the anemia of cancer and certain other chronic diseases. To better characterize the erythropoietin response in cancer patients, blood samples were analyzed from 81 anemic patients with solid tumors and 24 people with iron-deficiency anemia (control group). Results showed that the average level of erythropoietin was lower in the cancer patients than in the controls, while hemoglobin levels did not differ between the two groups. An inverse relationship between hemoglobin and erythropoietin levels was found in the controls, but not in the patients with cancer. In addition, the level of erythropoietin was lower for each given level of hemoglobin in the cancer patients. Chemotherapy further reduced the erythropoietin response to anemia, but there was no additional effect due to cisplatin chemotherapy. These results imply that the feedback loop that normally regulates erythropoietin production (in response to anemia) is impaired in cancer patients. For this reason, determining the erythropoietin level without taking the corresponding hemoglobin value into account (as has been done in some other studies) is not sufficient to assess the erythropoietin response in patients with cancer. Since some hypoxemic (oxygen deficient) cancer patients were able to produce erythropoietin, the ability to respond to anemia in this manner does not appear to vanish completely with the disease. These findings suggest that replacement therapy with erythropoietin may be beneficial for certain cancer patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Anemia, Measurement, Hemoglobin, Hemoglobins, Cancer, Erythropoietin

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The mechanism of respiratory failure in paraneoplastic pemphigus

Article Abstract:

The respiratory failure that occurs in patients with paraneoplastic pemphigus appears to be an autoimmune reaction against proteins in the lungs called plakins. This causes the epithelial cells to separate from the underlying basilar cells. These cells both occur in the tissue that lines the lung passages. Two patients with paraneoplastic pemphigus died from respiratory failure caused by this autoimmune reaction. Paraneoplastic pemphigus causes blistering of the skin and occurs in patients with certain types of cancer.

Paraneoplastic syndromes, Respiratory insufficiency, Pemphigus

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Transmission of a T-cell lymphoma by allogeneic bone marrow transplantation

Article Abstract:

Doctors describe the transmission of a T-cell lymphoma from a bone marrow donor to the recipient. T-cell lymphoma is a cancer of the immune system. Detailed investigation showed that the cancerous T cells taken from both patients were identical.

Diseases, Organ transplant recipients, Disease transmission, Bone marrow, Bone marrow transplantation, Lymphomas

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