Pure red cell aplasia induced by erythropoietin

Abstract

Introduction: Recombined human erythropoietin has been present in clinical practice for more than 20 years, in these therapeutic indications: anemia in kidney insufficiency, anemia during chemotherapy of tumors, prevention of anemias that appear in premature born babies, it is used for increasing autologous blood cell levels before blood transfusion, AIDS joined anemia (intensified by zidovudine), anemia joined with chronic inflammatory conditions such as rheumatoid arthritis(still in research phase). During the course of Erythropoietin treatment side effects have been noticed, that include multiple organ systems, and have different levels of frequency. Major number of studies shows connection between erythropoietin treatment and bone marrow aplasia, but small number of them states clearly defined side-effect that explains this phenomenon. Objective: Goal of this paper is to analyze available case studies of bone marrow aplasia during erythropoietin application, access their quality and causality of every study. Method: Research of literature used for the preparation of this systematic review has been conducted during the period of November-December 2017. In search for literature medical base PubMed has been used. Inclusion criteria were: available full article, publications in English language, publications conducted on humans, and case report studies. Eight studies passed selection. Results: results were presented by 5 charts: documentation size, credibility, number of case study reports of side-effects in the paper that was graded, Naranjo causality score, data extraction chart. Mean grade value of the studies quality was 7,0, while mean Naranjo score was 6,6.

A Case of Erythropoietin (EPO)-Induced Pure Red Cell Aplasia and Its Treatment Efficacy With Desidustat

“…Denaturation caused by a cold chain failure may be a critical inducer of antibody production related to the EPO stabilizer polysorbate-80 (PS-80). Studies have demonstrated that PS-80 can enhance drug immunogenicity and protein aggregation [13][14][15].…”