Possible new indications for the treatment with erythropoietin

The use of hematopoietic growth factors has increased rapidly during the la st decade. Among the growth factors available, erythropoietin (EPO) was the first growth factor to be used clinically. To date, EPO has shown activity in the treatment of the tumor-associated anemia and for correction of tumo r hypoxia, however, when compared with transfusion of erythrocytes EPO trea tment did not significantly prolong survival in cancer patients in any publ ished study so far. Recently, novel extramedullary EPO receptors have been identified leading t o a better understanding of the molecular mechanisms of action of EPO. Resu lts from these experiments and from several clinical studies suggest chat E PO treatment may be beneficial for patients with (chronic) infections (HIV, inflammatory bowel disease, septic episodes) and for treatment of the fati gue syndrome following cancer chemotherapy. In addition, EPO may also impro ve stem cell engraftment following high-dose chemotherapy and can increase survival rates of patients with aplastic anemia and myelodysplastic syndrom e. Currently, new EPO derivatives, synthetic fusion proteins and gene therapeu tic studies are under clinical investigation suggesting that the EPO-induce d effects may be increased significantly by these agents in the future.