Influence of X-Irradiation of the Dog Kidney on Erythropoietin Production

Fisher, James W.; Roh, Byung L.; Shenep, K.

doi:10.1159/000209617

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…Variability of target organ cell mass needs to be considered in those patients recovering from iatrogenic marrow aplasia as some of the early sEPO changes in the autologous and allogeneic groups may be related to differences in marrow erythroid regeneration and mass. The cytotoxic agents used in the pre-transplant conditioning regimens, with or without irradiation, might have been expected to suppress EPO production in humans just as alkylating agents were shown to do in the dog by Fisher & Roh (1964). Normal sEPO levels were however found, similar to the recent findings of Birgegard et a2 (1989).…”

Section: Discussionsupporting

confidence: 76%

Serum erythropoietin changes in autologous and allogeneic bone marrow transplant patients

et al. 1990

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Sequential changes in serum erythropoietin (sEPO) levels were measured by radioimmunoassay in six patients receiving autologous rescue (AR) and 11 patients receiving an allogeneic bone marrow transplant (BMT) for malignant disease. Longitudinal studies showed an inverse relationship between sEPO and haemoglobin levels in the autologous rescue and allogeneic transplant patients throughout the 130 d post-transplant study period. Early post-conditioning EPO responses were normal for the haemoglobin level in both groups, but after day 14 post-transplant, erythropoietin production in response to anaemia became impaired in one autologous rescue patient and eight of the 11 allogeneic transplant patients. There was no clear association between late impairment of sEPO production and conditioning therapy, infection, graft-versus-host disease, immunosuppressive therapy or serum creatinine. Blood transfusion requirements were similar for both groups in the first month after transplantation, but from days 31 to 90 post-transplant, BMT patients required an average of 5.5 units per patient compared with 1 unit per patient for the autologous group. Marrow transplant procedures do not affect early EPO responses but may diminish late responses. The potential value of exogenous rHuEPO in hastening engraftment and decreasing transfusion requirements, particularly for those patients who appear to have impaired EPO responses, remains to be shown by clinical trials.

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Section: Discussionsupporting

confidence: 76%

Serum erythropoietin changes in autologous and allogeneic bone marrow transplant patients

et al. 1990

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“…Nitrogen mustard was shown to enhance Epo response to anaemia in sheep (Magid & Hansen, 1966). On the other hand, chlorambucil or thioTEPA perfusion of the dog kidney depressed its ability to respond to cobalt with increased Epo production (Fisher & Roh, 1964).…”

mentioning

confidence: 94%

Marked erythropoietin increase before fall in Hb after treatment with cytostatic drugs suggests mechanism other than anaemia for stimulation

1989

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Serum erythropoietin (Epo) was measured in 23 patients before, during and after intensive cytostatic treatment courses for acute leukaemia or before bone marrow transplantation. A marked increase was seen in all patients, starting 1 or 2 d after initiation of treatment. A peak was reached after about 7 d, at levels as high as 1450 IU/l, after which Epo fell rapidly, even in patients who were anaemic at that time. In 13 of the patients there was no fall in Hb level that could explain the increase in Epo. The increase was too large to be explained by an altered Epo metabolism or marrow utilization. Cytostatic drugs cause an increase in Epo production not mediated through anaemia, possibly initiated by a cytostatic effect on the kidneys or by an unknown stimulatory factor, responsive to bone marrow inhibition.

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“…Apart from the paraneoplastic extrarenal production of EPO. several authors reported relatively low levels of EPO in malig nant disease [3], chronic inflammatory disease and AIDS [4][5][6], In patients with malignancies this relative lack of EPO deteriorated due to chemotherapy including Cisplatin and a variety of other chemotherapeutic drugs [3,[7][8][9]. In contrast to these findings, an increase of EPO levels before the onset of anemia was reported in children [10] and adults [11,12] with acute myelogenic or lymphatic leukemia treated by a variety of drugs including MTX, AraC and daunorubicin.…”

Section: Introductionmentioning

confidence: 99%

Inappropriate Increase in Plasma Erythropoietin Levels Following PEB Chemotherapy

Pohl¹,

Moter²,

Hasenclever³

et al. 1992

Oncol Res Treat

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Background: In order to obtain more information on the influence of chemotherapy on erythropoietin (EPO) regulation, the change of serum levels in correlation with the respective hemoglobin value was studied. Material and Methods: Six male patients (age 22-45 years) with testicular cancer were followed over a total of 21 cycles of chemotherapy according to the PEB regimen (Cisplatin 100 mg/m2, Etoposide 500 mg/m2, Bleomycin 60 mg/m2, total intravenous dose administered over 8 days, every 4 weeks). The EPO concentration was measured by radioimmunoassay. Sera from patients with acute blood loss or from healthy individuals served as controls. No impairment of renal or hepatic function was observed during or after PEB chemotherapy. Results: Prior to chemotherapy, EPO levels proved to be adequate when compared with the controls, ranging between 35 and 65 U/l at hemoglobin (Hb) levels above 12 g/dl. In the majority of cases chemotherapy was followed by merely mild anemia (Hb > 10 g/dl). Nevertheless, a 3.4-fold increase in EPO levels was observed during chemotherapy (35-354 U/l EPO, median 150 U/l). EPO levels were highest 6-8 days after the beginning of intravenous chemotherapy and then steadily declined, in most cases to even normal values prior to the next chemotherapy cycle. The elevation of EPO was significantly higher than that found in controls with a similar reduction of Hb levels due to acute blood loss. Conclusion: Chemotherapeutic agents or their combination are able to induce elevated EPO levels due to mechanisms unrelated to the anemia induced.

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Influence of X-Irradiation of the Dog Kidney on Erythropoietin Production

Cited by 8 publications

References 17 publications

Serum erythropoietin changes in autologous and allogeneic bone marrow transplant patients

Serum erythropoietin changes in autologous and allogeneic bone marrow transplant patients

Marked erythropoietin increase before fall in Hb after treatment with cytostatic drugs suggests mechanism other than anaemia for stimulation

Inappropriate Increase in Plasma Erythropoietin Levels Following PEB Chemotherapy

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