Dh. Biesma et al., RECOMBINANT-HUMAN-ERYTHROPOIETIN IN AUTOLOGOUS BLOOD-DONORS - A DOSE-FINDING STUDY, British Journal of Haematology, 86(1), 1994, pp. 30-35
A dose-finding study of recombinant human erythropoietin (rhEPO) was p
erformed in 60 autologous donors who donated 2 units of blood prior to
orthopaedic or vascular surgery. The correction of phlebotomy-induced
anaemia was studied in four groups of 15 patients who received 500 U/
kg, 250 U/kg, 125 U/kg or no (controls) rhEPO subcutaneously twice per
week during a 3-week period. Haemoglobin concentration in the 500 U/k
g, 250 U/kg and 125 U/kg group and in the controls reached respectivel
y 99.2, 98.8, 91.9 and 87.1% of pre-phlebotomy value. Flow cytometric
analysis of reticulocytes showed a steady increase of reticulocyte cou
nt as the dose increased. Maximal levels of high fluorescence reticulo
cytes which represent early changes of erythropoiesis were reached aft
er 7 d and decreased thereafter in each group. Serum ferritin decrease
d significantly to approximately 50% of baseline values in all groups;
no differences in the decrease of serum ferritin were observed betwee
n the patients who received rhEPO and the controls. No severe adverse
events were observed. This study demonstrates a dose-related effect of
rhEPO on erythropoiesis in autologous donors during the first 2 weeks
. No further increase of reticulocytes was observed despite continued
rhEPO therapy, which may be due to the inability of the mononuclear ph
agocytic system to release additional iron. To restore pre-phlebotomy
haemoglobin concentration, a dose of 250 U/kg rhEPO was sufficient.