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Serum erythropoietin levels and blood component therapy after autologous bone marrow transplantation: implications for erythropoietin therapy in this setting.

Publication ,  Journal Article
Lazarus, HM; Goodnough, LT; Goldwasser, E; Long, G; Arnold, JL; Strohl, KP
Published in: Bone Marrow Transplant
July 1992

To determine the potential impact of recombinant human erythropoietin (EPO) therapy in patients undergoing autologous bone marrow transplantation (BMT) and colony-stimulating factor therapy, we assayed endogenous serum EPO levels and noted blood transfusion requirements in relapsed non-Hodgkin's lymphoma patients treated with high-dose chemo-radiation therapy and autologous BMT. Hematocrit and reticulocyte counts were determined daily, and hematocrit was maintained in the 25-30% range by transfusion according to criteria established by our hospital transfusion committee. EPO levels were measured by radioimmunoassay and were determined at baseline, throughout therapy, and 2 and 3 months after BMT. Serum EPO levels increased more than 25-fold above baseline in most subjects after initiating chemoradiation therapy. No correlation was noted between serum EPO and hematocrit, reticulocyte count or serum creatinine. Total red blood cell units transfused ranged from 4 to 15 (mean 7.7). Mean total donor exposures (red blood cell plus platelet units transfused) were 83.6 units (range 16-175). Serum EPO levels increased early in the course of preparation for autologous BMT and remained elevated for at least 2-3 weeks thereafter although at a lower level. Red blood cell transfusions were required despite very high EPO levels after BMT. Red cell transfusions, moreover, accounted for only 9.2% (69 of 746) of total donor exposures and only 5.8% (42 of 746) of donor exposures during the interval when pharmacologic doses of erythropoietin might be of benefit. In contrast to the potential benefit of colony-stimulating factors such as G-CSF and GM-CSF in BMT, our study suggests limited value for erythropoietin therapy in this setting.

Duke Scholars

Published In

Bone Marrow Transplant

ISSN

0268-3369

Publication Date

July 1992

Volume

10

Issue

1

Start / End Page

71 / 75

Location

England

Related Subject Headings

  • Transplantation, Autologous
  • Middle Aged
  • Male
  • Lymphoma, Non-Hodgkin
  • Immunology
  • Humans
  • Female
  • Erythropoietin
  • Bone Marrow Transplantation
  • Blood Transfusion
 

Citation

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Lazarus, H. M., Goodnough, L. T., Goldwasser, E., Long, G., Arnold, J. L., & Strohl, K. P. (1992). Serum erythropoietin levels and blood component therapy after autologous bone marrow transplantation: implications for erythropoietin therapy in this setting. Bone Marrow Transplant, 10(1), 71–75.
Lazarus, H. M., L. T. Goodnough, E. Goldwasser, G. Long, J. L. Arnold, and K. P. Strohl. “Serum erythropoietin levels and blood component therapy after autologous bone marrow transplantation: implications for erythropoietin therapy in this setting.Bone Marrow Transplant 10, no. 1 (July 1992): 71–75.
Lazarus HM, Goodnough LT, Goldwasser E, Long G, Arnold JL, Strohl KP. Serum erythropoietin levels and blood component therapy after autologous bone marrow transplantation: implications for erythropoietin therapy in this setting. Bone Marrow Transplant. 1992 Jul;10(1):71–5.
Lazarus HM, Goodnough LT, Goldwasser E, Long G, Arnold JL, Strohl KP. Serum erythropoietin levels and blood component therapy after autologous bone marrow transplantation: implications for erythropoietin therapy in this setting. Bone Marrow Transplant. 1992 Jul;10(1):71–75.

Published In

Bone Marrow Transplant

ISSN

0268-3369

Publication Date

July 1992

Volume

10

Issue

1

Start / End Page

71 / 75

Location

England

Related Subject Headings

  • Transplantation, Autologous
  • Middle Aged
  • Male
  • Lymphoma, Non-Hodgkin
  • Immunology
  • Humans
  • Female
  • Erythropoietin
  • Bone Marrow Transplantation
  • Blood Transfusion