Background and objectives: Intravenous (i.v.) Recombinant erythropoietin
(Epoetin alfa) is effective in allowing autologous blood donation in patients unable
to donate because of anemia. We undertook this open pilot study in order to
asses whether a low subcutaneous (s.c.) dose of Epoetin alfa would prove as effective
and well tolerated as the higher i.v. dose. Such a move would also decrease
costs. Materials and methods: A total Epoetin alfa s.c. dose of 800 IU/kg was
compared with a total i.v. dose of 1,800 IU/kg. Twenty-two rheumatoid arthritis
patients, unable to donate because of hemoglobin (Hb) <11 g/dl, received 300
IU/kg of IV Epoetin alfa twice weekly for 3 weeks (11 patients), or 100 IU/kg of
s.c. Epoetin alfa twice weekly for 3 weeks plus an i.v. bolus of 200 IU/kg of
Epoetin alfa at the first visit (11 patients). At each visit, all patients received 100
mg of i.v. iron saccharate and when the hematocrit (hct) > 34%, 350 ml of autologous
blood (AB) were collected. Results: No significant differences were observed
between the 2 groups of treated patients in terms of units of AB collected
(2.6±0.6 vs. 2.5±0.5 units for i.v. and s.c. groups, respectively), ml of RBC produced
during the study period (291+99 vs. 337±65 ml for the i.v. and s.c. groups,
respectively), or in the degree of reduced exposure to allogeneic blood in comparison
with the control group. Conclusions: Lower dose of Epoetin alfa (reduced
by 56%), supplemented by i.v. iron, is as effective and well tolerated as
higher doses administered i.v., supplemented by i.v. iron.
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