HIGH-DOSE RECOMBINANT-HUMAN-ERYTHROPOIETIN STIMULATES RETICULOCYTE PRODUCTION IN PATIENTS WITH MULTIPLE ORGAN DYSFUNCTION SYNDROME

Objective: To investigate erythropoietin (EPO) production and the eryt hropoietic potency of recombinant human EPO in the multiple organ dysf unction syndrome. Design: Randomized, prospective, controlled clinical trial. Materials and Methods: Patients received either 600 IU/kg intr avenous EPO three times weekly (n = 9) or saline (control, n=10). Meas urements: EPO levels, circulating soluble receptors for tumor necrosis factor and interleukin-2, levels of interleukin-6 and intercellular a dhesion molecule, and early peripheral blood cell progenitors. Results : EPO production in the control group remained low. Pharmacologic EPO blood levels were associated with increased reticulocyte counts compar ed with both controls (p < 0.04) and baseline (p < 0.006), Increased l evels of soluble receptors for tumor necrosis factor in the treatment group compared with the controls did not prevent this effect, Interleu kin 6 inhibited reticulocyte production. Conclusion: Despite increased cytokine levels, pharmacologic EPO blood levels were associated with increased reticulocyte counts in patients with multiple organ dysfunct ion syndrome.