| Theme |
Problems to be solved in the therapy for renal anemia : Association of ESA hyporesponsiveness with dysregulated iron metabolism |
| Title |
Low ESA reactivity : hematologists' viewpoint |
| Author |
Masaya Okada |
Division of Hematology, Department of Internal Medicine, Hyogo Medical College |
| Author |
Hiroyasu Ogawa |
Division of Hematology, Department of Internal Medicine, Hyogo Medical College |
| [ Summary ] |
There are various causes of low ESA reactivity. Differential diagnosis of hematological disorders such as multiple myeloma and iron deficiency anemia is particularly important. MCV is useful in differential diagnosis of anemia. Currently, it is not possible to perform ESA therapy for bone marrow failure in Japan. However, ESA treatment for myelodysplastic syndrome is recommended in the NCCN guidelines. The majority of patients with bone marrow failure present with anemia and will become dependent on regular transfusions with the associated risk of iron overload. Iron chelation has been reported to improve overall survival. Recently, guidelines for transfusion induced iron overload and iron chelation therapy have been created. |