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      Circulating Burst-Forming-Unit Erythroid and the Responsiveness to Recombinant Human Erythropoietin in Patients on Regular Hemodialytic Treatment

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          The dose of recombinant human erythropoietin (r-HuEpo) required to correct anemia of end-stage renal disease varies among patients. The possible factors that interfere with the responsiveness to r-HuEpo were not completely known. In 32 patients on regular hemodialytic treatment with marked anemia (Hb 5.6 ± 0.7 g/dl), we evaluated circulating erythroid progenitor cells [burst-forming-unit erythroid (BFU-E)], erythropoietin, ferritin, folate and 1-84-parathormone levels before r-HuEpo therapy. In 12 patients, the aluminum levels after deferoxamine were also evaluated. The possible correlation between these factors and the response to r-HuEpo therapy was then evaluated. The number of circulating (c) BFU-E was highly variable (521 ± 447 colonies/ml of blood; normal level 742 ± 192) and does not correlate with erythropoietin, ferritin, folate, 1-84-parathormone or aluminum levels. A direct correlation between basal cBFU-E and the responsiveness to r-HuEpo therapy was recorded while no correlation was found with the other analyzed parameters. We hypothesized that low basal cBFU-E (interleukin-3 deficiency?) could reduce the response to r-HUEpo because of failure of this hematopoietic stem cell compartment to replenish the pool of more mature erythropoietic progenitor cells during the phase of accelerated maturation induced by r-HuEpo.

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          Author and article information

          S. Karger AG
          12 December 2008
          : 62
          : 2
          : 150-154
          aDivisione Nefrologia e Dialisi, Ospedale Niguarda Cà Granda; bIstituto di Medicina Intema, Università di Milano, Milano; cClinica Medica, Istituto di Scienze Biomediche S. Gerardo, Università di Milano, Monza, Italia
          187024 Nephron 1992;62:150–154
          © 1992 S. Karger AG, Basel

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          Page count
          Pages: 5
          Original Paper

          Cardiovascular Medicine, Nephrology

          Burst-forming-uniterythroid, Erythropoietin, Renal anemia


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