Anemia iron deficiency.pptxAnemia iron deficiency.pptx

Anemia iron deficiency.pptxAnemia iron deficiency.pptx

1. TREATMENT OF ANEMIA

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9. Hematopoietic Growth Factors Naturally: Clinically (drugs): Scientists use recombinant DNA technology to produce synthetic (lab-made) versions of these natural proteins. That’s why we call them recombinant growth factors . Erythropoietin (EPO) → stimulates RBCs G-CSF → stimulates neutrophils GM-CSF → stimulates granulocytes + macrophages Thrombopoietin (TPO) → stimulates megakaryocytes → platelets IL-11 → stimulates megakaryocytes → platelets

10. Erythropoiesis-Stimulating Agents (ESAs) Normal erythropoietin (EPO) made by kidney → stimulates bone marrow to make RBCs. In renal failure → less EPO → anemia. Drugs: Epoetin alfa (recombinant EPO). Darbepoetin alfa (longer acting, glycosylated). Methoxy PEG-epoetin beta (very long-acting, 1–2/month). Uses: Anemia of renal failure, chemo/HIV, bone marrow disorders. Adverse effects: Hypertension, thrombosis. Do not let Hb > 12 g/dL → risk of mortality, CV events.

11. Myeloid Growth Factors Filgrastim (G-CSF): stimulates neutrophils . Sargramostim (GM-CSF): stimulates neutrophils + macrophages + megakaryocytes . Uses: Speed up neutrophil recovery after chemo. Treat congenital or acquired neutropenia. Mobilize stem cells before transplantation Adverse effects: G-CSF → mild bone pain. GM-CSF → more severe: fever, joint pain, capillary leakage, edema. Pegfilgrastim : Long-acting form of G-CSF.

12. Megakaryocyte Growth Factors IL-11 ( Oprelvekin ): ↑ platelet production. Use: Prevent thrombocytopenia after chemo. Side effects: Fatigue, headache, dizziness, fluid retention. Romiplostim: SC injection, thrombopoietin receptor agonist. Use: Chronic idiopathic thrombocytopenia (ITP). Eltrombopag : Oral thrombopoietin receptor agonist. Use: Chronic ITP not responding to other treatment. Risk: Hepatotoxicity + bleeding , restricted use.