EFFECT OF ANDROGEN THERAPY AND ANEMIA ON SERUM ERYTHROPOIETIN LEVELS IN PATIENTS WITH APLASTIC-ANEMIA AND MYELODYSPLASTIC SYNDROMES

Immunoreactive serum erythropoietin (EPO) was measured in anemic and n on-anemic patients with acquired non-severe aplastic anemia (AA; n = 2 2) and myelodysplastic syndromes (MDS; n = 31) receiving or not androg ens to examine the effect of androgen therapy and anemia on EPO levels in these disorders. Soluble transferrin receptor (TfR) and absolute r eticulocyte count (ARC) were also assayed in order to evaluate erythro poietic activity, AA and MDS patients were stratified for anemia and a ndrogen treatment as follows: 12 untreated anemic patients; 17 anemic patients during androgen therapy; 14 non-anemic patients without any t reatment (> 1 year); and 10 non-anemic patients on androgen therapy. A lthough EPO levels in non-anemic patients were significantly higher th an in healthy controls (n = 29) no statistically significant differenc es in Hb and EPO values were found between non-anemic patients receivi ng or not androgen therapy. In the linear regression analysis between Hb and log EPO concentration, no statistically significant differences in the slopes between untreated and androgen-treated anemic groups no r between both groups and patients with iron deficiency anemia (n = 23 ) were observed. However, the y intercept (log EPO) of regression line was significantly higher in androgen-treated anemic patients than in the androgen therapy-free anemic group. Serum TfR levels were higher i n treated than in untreated anemic patients, whereas ARC was not diffe rent between both groups, These data seemingly indicate that (I) andro gens at pharmacological doses do not increase serum EPO levels in non- anemic AA and MDS patients, and (2) in patients with AA and MDS, andro gen-driven EPO stimulation is appreciably enhanced by anemia. (C) 1998 Wiley-Liss, Inc.