The Effect of Patient Size and Dose of Recombinant Human Erythropoietin Therapy on Red Blood Cell Volume Expansion in Autologous Blood Donors for Elective Orthopedic Operation

Abstract In an attempt to reduce or eliminate homologous red blood cell transfusion requirements during allogeneic bone marrow transplantation (BMT), we instituted a novel program whereby recombinant human erythropoietin was administered to pairs of BMT donors and recipients. Eleven recipients and their HLA-matched donors were enrolled. Donors treated with recombinant human erythropoietin (rHuEPO) were phlebotomized a median of 6 U (range, 4 to 11 U) of blood over a 5-week period. This donor-derived blood was available to the BMT donor or recipient as needed. Transplant recipients were also treated with rHuEPO post-BMT to hasten erythropoiesis. Five of 11 BMT recipients underwent transplant receiving only donor-derived red blood cell transfusion, compared with 0 of 11 concomitant control recipients (P = .04). In addition, the time to absolute reticulocyte count > or = 10(4)/microL was statistically shorter in the rHuEPO-treated recipient group. This study serves as a paradigm for hematopoietic growth factor use in allogeneic BMT to decrease or eliminate homologous transfusion exposures and to possibly hasten hematopoietic engraftment.

Download Full-text

Use of recombinant human erythropoietin in allogeneic bone marrow transplant donor/recipient pairs

Blood ◽

10.1182/blood.v83.7.1952.bloodjournal8371952 ◽

1994 ◽

Vol 83 (7) ◽

pp. 1952-1957 ◽

Cited By ~ 1

Author(s):

AJ Mitus ◽

JH Antin ◽

CJ Rutherford ◽

CJ McGarigle ◽

MA Goldberg

Keyword(s):

Bone Marrow ◽

Blood Cell ◽

Red Blood Cell ◽

Recombinant Human Erythropoietin ◽

Allogeneic Bone Marrow Transplantation ◽

Allogeneic Bone Marrow ◽

Red Blood Cell Transfusion ◽

Allogeneic Bone ◽

Human Erythropoietin ◽

Transfusion Requirements

In an attempt to reduce or eliminate homologous red blood cell transfusion requirements during allogeneic bone marrow transplantation (BMT), we instituted a novel program whereby recombinant human erythropoietin was administered to pairs of BMT donors and recipients. Eleven recipients and their HLA-matched donors were enrolled. Donors treated with recombinant human erythropoietin (rHuEPO) were phlebotomized a median of 6 U (range, 4 to 11 U) of blood over a 5-week period. This donor-derived blood was available to the BMT donor or recipient as needed. Transplant recipients were also treated with rHuEPO post-BMT to hasten erythropoiesis. Five of 11 BMT recipients underwent transplant receiving only donor-derived red blood cell transfusion, compared with 0 of 11 concomitant control recipients (P = .04). In addition, the time to absolute reticulocyte count > or = 10(4)/microL was statistically shorter in the rHuEPO-treated recipient group. This study serves as a paradigm for hematopoietic growth factor use in allogeneic BMT to decrease or eliminate homologous transfusion exposures and to possibly hasten hematopoietic engraftment.

Download Full-text