Circulating erythropoietin levels after bone marrow transplantation:
inappropriate response to anemia in allogeneic transplants
Y Beguin, GK Clemons, R Oris and G Fillet
Department of Hematology, University of Liege, Belgium.
We studied 24 recipients of autologous bone marrow transplantation (ABMT)
or allogeneic BMT (BMT) to determine whether impaired erythropoietin (Epo)
response to anemia could delay full erythropoietic recovery. Observed Epo
levels were compared with predicted levels based on the relationship
between Epo and hematocrit in 125 control subjects. Circulating Epo levels
were normal during conditioning and the early posttransplant period.
Between days 21 and 180, Epo levels remained normal in ABMT patients but
were inappropriately low for the degree of anemia in BMT patients. Median
time to full erythropoietic engraftment was longer in BMT than in ABMT
recipients. Circulating Epo returned to appropriate levels after day 180,
except in patients with active cytomegalovirus infection. We conclude that
impaired Epo response to anemia can contribute to delayed erythropoietic
recovery after allogenic BMT. Renal toxicity of ciclosporin, interaction
between host and donor marrow, and cytomegalovirus infection might play a
role. This study could support the use of recombinant human Epo to
accelerate erythropoietic engraftment after BMT.
Volume 77,
Issue 4,
pp. 868-873,
02/15/1991
Copyright © 1991 by The American Society of Hematology
