High-Dose Recombinant Human Erythropoietin Stimulates Reticulocyte Production in Patients with Multiple Organ Dysfunction Syndrome

Abstract

Despite increased cytokine levels, pharmacologic EPO blood levels were associated with increased reticulocyte counts in patients with multiple organ dysfunction syndrome.

Prospective Randomized Double-Blind Placebo Controlled Trial of Recombinant Human Erythropoietin Administration to Reduce Blood Transfusions in Anemic Pediatric Intensive Care Patients

“…rHuEPO may take days until its onset of action, and potentially weeks until its peak effects are observed. This conclusion is also supported by work done by Gabriel et al 10 In their study, 19 adults with multiple organ dysfunction received 3 weeks of rHuEPO, 600 units/kg IV three times per week, with iron. While rHuEPO significantly increased the erythrocyte count measured, it failed to demonstrate a significant decrease in the need for RBC transfusions.…”

“…Two other studies that failed to demonstrate a reduction in the number of RBC units transfused also administered rHuEPO intravenously. 10,13 The analyses conducted in this study were under-powered due to the small sample sizes. As previously stated the target number of patients for this study was 100; however, due to difficulty in enrolling patients, the study was stopped prematurely.…”

Erythropoietin-receptor agonists in critically ill patients: a meta-analysis of randomized controlled trials

“…1,[8][9][10][11][12][13][14][15] In an effort to overcome the relative erythropoietin deficiency observed in critically ill patients, recombinant erythropoietin has been used to stimulate erythropoiesis, mitigate anemia and reduce the need for blood transfusions. Early proof-ofconcept studies were generally small and focused on hematologic response as an outcome measure.…”

“…All of the studies were published in peer-reviewed, English-language journals and were sponsored by the same parent company. 1,[8][9][10][11][12][13][14][15] Five of the studies were conducted in North America, 1,8,9,12,13 and 4 were conducted in Europe. 10,11,14,15 Of the 9 studies, 4 enrolled more than 100 patients.…”

“…All of the trials compared erythropoietin alpha with either a placebo 1,[8][9][10]12,13,15 or no therapy. 11,14 No eligible studies of darbepoietin were identified.…”