B. Meister et al., THE EFFECT OF RECOMBINANT-HUMAN-ERYTHROPOIETIN ON CIRCULATING HEMATOPOIETIC PROGENITOR CELLS IN ANEMIC PREMATURE-INFANTS, Stem cells, 15(5), 1997, pp. 359-363
In vitro and animal studies suggest that high concentrations of recomb
inant human erythropoietin (rHuEPO) might divert multipotent progenito
rs into erythroid maturation at the expense of granulocyte production.
We determined whether changes of number and lineage commitment of per
ipheral blood progenitor cells occur in premature infants during thera
py with rHuEPO. Thirty preterm infants were randomly assigned either t
o receive 300 IU of eopoetin alpha s.c. per kilogram body weight three
times a week for four weeks or to a control group. At study entry and
after two weeks of treatment the numbers of circulating BFU-E, granul
ocyte-macrophage colony-forming units (CFU-GM) and granulocyte-erythro
cyte-macrophage-megakaryocyte CFU (CFU-GEMM) were analyzed by semisoli
d culture technique, CD34(+) cells and early myeloid CD34(+)CD45RA(-)
progenitors by flow cytometry. As compared with the control group, rHu
EPO treatment did not exert any significant modulatory effect on numbe
rs of CFU-GM, nor was there a significant change in numbers of BFU-E,
CFU-GEMM, total-CFU, percentage of CD34(+) or CD34(+)CD45RA(-) cells.
Mean neutrophil count was not significantly reduced at any period duri
ng the study. Compared with the control group, the infants receiving r
HuEPO had higher hematocrit values (p = 0.003) and absolute reticulocy
te counts (p < 0.001). The median cumulative volume of blood transfuse
d per kilogram per day was 0.86 ml (first quartile 0.5 ml; third quart
ile 1.1 ml) in the control group and 0 ml (first quartile 0 ml; third
quartile 0.47 ml) in the rHuEPO group (p = 0.038). We conclude using a
relatively high dose of rHuEPO in premature infants, no significant i
n vivo effect on circulating peripheral blood progenitor or neutrophil
count could be detected.