Erythropoietin Use in Therapy of Anemia Associated with Bone Marrow Transplantation in Children

  • A. Chybicka
  • E. Gorczynska
  • J. Boguslawska-Jaworska
  • D. Kurpas

Abstract

Erythropoietin (EPO) is a hematopoietic growth factor that plays a vital role in erythropoiesis regulating the red blood cell synthesis. EPO is a hormone-like glycoprotein (molecular weight 24 000 daltons) that regulates the red blood cell synthesis and the proliferation and maturation of erythroid cells in bone marrow [1]. Its concentration is related to the degree of anemic hypoxia. Recombinant DNA technology has permitted the production of sufficient amounts of recombinant human EPO (rhEPO) for clinical application [2]. Endogenous EPO production becomes inadequate in most recipients of megachemotherapy and bone marrow transplantation 2–3 weeks after transplantation. During this time, erythrocyte transfusions are required [3]. Recombinant EPO, which was first successfully applied in anemic patients with chronic renal failure, is increasingly being used to treat chronic anemia in cancer and patients after BMT [4,7,9,10,11,15].

Keywords

Placebo Leukemia Anemia Erythropoietin Allo 

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References

  1. 1.
    Link H, Brune T., Hubner G, Diedrich H, Freund M, Stoll M, Peest D, Ebell W, Bettoni C, Oster W, Nicolay U. Heinrichs H. Effect of recombinant human erythropoietin after allogeneic bone marrow transplantation. Ann. Hematol. 1993, 67, 169–173PubMedCrossRefGoogle Scholar
  2. 2.
    Abels R. J, Rudnick S. A. Erythropoietin evolving clinical applications, Exp. Hematol. 1991, 19, 842–850PubMedGoogle Scholar
  3. 3.
    Miller CB. Erythropoietin in high-dose chemotherapy. In: J. Armitage, K. Antman (eds), High-dose Cancer Therapy, Pharmacology, Hematopoietins, Stem cells, 1st Edition, Wilkins and Wilkins, Maryland PP385–401, 1992Google Scholar
  4. 4.
    Link H, Diedrich H, Ebell W, et al. Recombinant human erythropoietin after allogenic bone marrow transplantation. Bone marrow transplantation 1990; Suppl. 2: 219aGoogle Scholar
  5. 5.
    Pangalis G., Poziopoulos Ch, Angelopoulos M, Siakantarss M, Pantayiodios. Effective treatment of disease related anemia in B-chronic lymphocytic leukemia patients with recombinant human erythropoietin. Brit. J. Hematol. 1995, 89, 627–629CrossRefGoogle Scholar
  6. 6.
    Kuratowska Z. Erythropoietin use in hematological patients. Acta Hematol. Polon. 1997, 28 suppl. 2 73–82Google Scholar
  7. 7.
    Dornbusch P., Clinical efficacy of r-HuEPO in the treatment of cancer-related anemia in pediatric patients, Erythropoiesis. 1996, 1Google Scholar
  8. 8.
    Backs B, Broeders L., Hoefslood D, et al. Erythropoieis in myelodysplastic syndrome: expression of receptor for erythropoietin and kit-ligand. Leukemia 1996, 3, 396–401.Google Scholar
  9. 9.
    Sevelda P, Kurtz Ch., Marth Ch., Prospective randomized placebo controlled trial of erythropoietin (erypo) in patients with chronic anemia and gynecological cancer. Por Am Assoc Clin Oncol 1996, 15, 287Google Scholar
  10. 10.
    Goy A, Belanger C, Casadevall N, et al. High doses of intravenous recombinant erythropoietin for the treatment of anemia in myelodysplastic syndrome. Br J Haematol 1993; 84: 232–237PubMedCrossRefGoogle Scholar
  11. 11.
    Hansen P. B., Hippe E., Hellstrom-Lindberg E., Ralfkier E. Recombinant human granulocyte macrophage colony stimulating factor plus erythropoietin may improve anemia in selected patients with myelodysplasia. Am. J. of Hematol 1993, 44, 229–236.CrossRefGoogle Scholar
  12. 12.
    Hellstrom-Lindengerg E., Efficacy of erythroprotein in myelodysplastic syndromes; a meta analysis of 205 patients from 17 studies. Brit. J Hematol, 1995, 44, 229–236.Google Scholar
  13. 13.
    Rose E., Rai K., Revicki D, Brown R., Reblando J., Clinical and health staus assesments in anemic chronic lymphocytic (CLL) patients treated with epoietin alfa (EPO) Blood, 1994, 84, 52Google Scholar
  14. 14.
    Podsakoff G. M, Paszty M, Narla M et al. Improvement of anemia of murine beta talasemia following administration of the erythropoietin gene. Acta Hematol. 1997, S1, 98, 10, 3Google Scholar
  15. 15.
    Ludwig H. Prediction of response to erythropoietin treatment in chronic anemia of cancer. Blood 1994, 84, 1056–1072PubMedGoogle Scholar
  16. 16.
    Ayash L, Elias A., et al. Recombinant human erythropoietin (EPO) in anemia associated with autologous bone marrow transplantation (ABMT) Blood 1990, 76 suppl. 1, 131 a.Google Scholar
  17. 17.
    Zecca M., Erythropoietin treatment in pediatrics. Oncology Reviev, 1992, 7, 518Google Scholar
  18. 18.
    Remaggi G., Milone G., Fernandez I., Martinez Rolon J., Desmery P., Pavlovsky S., Evaluation oh human recombinant erythropoietin use in autologus peripheral progenitor cell transplant. Blood vol. 90, No 10, Suppl. 2, 362b.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2000

Authors and Affiliations

  • A. Chybicka
    • 1
  • E. Gorczynska
    • 1
  • J. Boguslawska-Jaworska
    • 1
  • D. Kurpas
    • 1
  1. 1.Department of Children’s Hematology and OncologyWroclaw University of MedicineWroclawPoland

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