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Circulating haematopoietic progenitors during treatment of renal anaemia with recombinant human erythropoietin

  • Nephrology/Urology
  • Original Paper
  • Published:
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Abstract

The effect of recombinant human erythropoietin (rhEPO) and interleukin 3 (IL3) on circulating haematopoietic progenitors consisting mainly of immature burst-forming-units-erythrocytes (BFU-E), was investigated in ten paediatric patients treated by regular haemodialysis. During a 30-week study rhEPO treatment resulted in a rise of median haemoglobin levels from 6.7 g/dl to >10 g/dl in all patients. Before initiating rhEPO treatment the number of circulating BFU-E in chronic renal failure patients responded to grading doses of rhEPO in vitro similar to that in control children; however, the dose-response curves were not predictive for the in vivo response to rhEPO. After an initial rise in five patients BFU-E numbers declined by week 30 of rhEPO treatment. BFU-E numbers decreased to 35% of pretreatment values. The number of granulocyte-macrophage colony forming cells (GM-CFC) also decreased during rhEPO treatment. Addition of IL3 to the culture medium containing saturating concentrations of granulocyte-macrophage colony stimulating factor did not stimulate BFU-E numbers of patients before rhEPO treatment or those of controls. However, 2 weeks after start of rhEPO treatment IL3 increased the growth of patient's BFU-E in vitro to 220% of pretreatment levels, followed by a gradual decrease of stimulation until the end of observation. These findings indicate that: (1) long-term recruitment of circulating haematopoietic progenitors during rhEPO treatment is low in children with renal anaemia; (2) rhEPO sensitivity of circulating BFU-E is not predictive for the in vivo response; (3) rhEPO treatment results in enhanced sensitivity of BFU-E to IL3.

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Abbreviations

BFU-E :

burstforming-units erythroid

CFU-E :

colony forming-units erythroid

CRF :

chronic renal failure

EPO :

erythropoietin

GM-CFC :

granulocyte-macrophage colony forming cells

GM-CSF :

granulocyte-macrophage colony stimulating factor

IL3 :

interleukin 3

rhEPO :

recombinant human erythropoietin

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Authors and Affiliations

  1. Sektion für Onkologie/Immunologie, Universitäts-Kinderklinik, Im Neuenheimer Feld 150, D-69120, Heidelberg, Germany

    Verena Göbel, Hans-Georg Hoffmann, Rolf Ludwig & Klaus-Michael Debatin

  2. Sektion für pädiatrische Nephrologie, Universitäts-Kinderklinik Heidelberg, Im Neuenheimer Feld 150, D-69120, Heidelberg, Germany

    Dirk E. Müller-Wiefel, Andrea Braun & Karl Schärer

Authors
  1. Verena Göbel
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  2. Hans-Georg Hoffmann
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  3. Dirk E. Müller-Wiefel
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  4. Andrea Braun
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  5. Rolf Ludwig
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  6. Karl Schärer
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  7. Klaus-Michael Debatin
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Göbel, V., Hoffmann, HG., Müller-Wiefel, D.E. et al. Circulating haematopoietic progenitors during treatment of renal anaemia with recombinant human erythropoietin. Eur J Pediatr 153, 43–48 (1994). https://doi.org/10.1007/BF02000786

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  • DOI: https://doi.org/10.1007/BF02000786

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