Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
Effects and uses of erythropoietin (Meeting abstract).
International Conference on Growth Factors in Cancer Therapy. September 25-26, 1992, Nashville, TN, 1992.. Unique Identifier : AIDSLINE ICDB/94697111 Adamson JW; New York Blood Center, New York, NY
Abstract:
Erythropoietin (Epo) is the hormone in animals and man which regulates the day-to-day production of RBC. Epo is made by peritubular capillary lining cells of the kidney in response to hypoxia, circulates in the plasma, and then interacts with its target cells in the marrow. Epo binds to specific cell surface receptors belonging to the superfamily of hematopoietic growth factor receptors. This superfamily includes receptors for many of the interleukins as well as progesterone and growth hormone. Epo also affects the maturation of megakaryocytes under highly defined in vitro conditions but plays little, if any, role in the in vivo regulation of platelet production. Recombinant human Epo, made available in 1985 for clinical trials, has established itself as a major therapeutic for the correction of the anemia associated with chronic renal failure. More recently, recombinant human Epo was approved for the use in anemic AIDS patients receiving AZT. Ongoing or recently completed clinical trials of Epo have demonstrated its effectiveness in ameliorating the anemia associated with many chronic diseases such as rheumatoid arthritis and a variety of malignancies. Studies of recombinant Epo in the perisurgical setting have demonstrated its ability to enhance red cell production to enable individuals who would otherwise not be able to predeposit blood prior to elective surgery to do so. In a large randomized, placebo controlled and doubly blinded clinical trial in individuals undergoing coronary artery bypass surgery, Epo administration prior to, during and following the surgical procedure led to a substantial reduction in exposure to homologous blood. Preliminary results also suggest a positive role for Epo therapy to correct the anemia of severe prematurity and as an adjunct in the enhancement of fetal hemoglobin production in individuals with hemoglobinopathies such as sickle cell disease. In summary, recombinant human Epo has had a major impact in reducing exposure to homologous blood in a variety of clinical settings, correcting the anemia of chronologically debilitated individuals and, thereby, improving quality of life. Work remains to identify those subgroups of patients most likely to respond to Epo therapy in order to target its use appropriately and with the greatest cost-effectiveness.
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/DRUG THERAPY Anemia/CHEMICALLY INDUCED/COMPLICATIONS/*THERAPY Clinical Trials Costs and Cost Analysis Erythropoietin/PHARMACOLOGY/*THERAPEUTIC USE Human Recombinant Proteins/PHARMACOLOGY/THERAPEUTIC USE Zidovudine/ADVERSE EFFECTS ABSTRACT 940430
M9440916
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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.
