THE EFFICACY OF SUBCUTANEOUS RECOMBINANT-HUMAN-ERYTHROPOIETIN IN THE CORRECTION OF PHLEBOTOMY-INDUCED ANEMIA IN AUTOLOGOUS BLOOD-DONORS

The efficacy of subcutaneous recombinant human erythropoietin (rhEPO) (500 U/kg; administered twice a week during the 3 weeks before surgery ) in the recovery of preoperative hemoglobin concentrations within a 3 -week period was studied in 40 patients, each of whom donated 2 units (900 mL) of blood for their own use before total hip replacement surge ry. Twenty autologous blood donors received rhEPO (EPO group) and 20 w ere not treated (control group). The initial hemoglobin concentration (14.0 +/- 1.0 g/dL [140 +/- 10 g/L]) was completely recovered before s urgery (14.0 +/- 1.6 g/dL [140 +/- 16 g/L]) in the EPO group, while a decrease from 13.8 +/- 1.1 to 12.2 +/- 1.3 g per dL (138 +/- 11 to 122 +/- 13 g/L) was observed in the control group. The preoperative retic ulocyte count showed more than sixfold increase in the EPO group, wher eas a twofold to threefold increase was found in the control group. Se rum ferritin concentration fell to 42 +/- 29 mug per L in the EPO grou p and to 54 +/- 35 mug per L in the control group. The postoperative s erum erythropoietin concentration in the EPO group was significantly l ower than that in the control group, but it did not differ from the pr etreatment value and was attended by a higher hemoglobin concentration after surgery. Only transient flu-like symptoms were mentioned by pat ients who were treated with rhEPO. Changes in blood pressure or platel et count or other adverse events were not observed. This study demonst rates that subcutaneous rhEPO is safe and effective for the complete c orrection of the loss of 2 units of blood within a 3-week period.