Serum level of erythropoietin in anemias associated with chronic infection, malignancy, and primary hematopoietic disease

Ward, Harry P.; Kurnick, John E.; Pisarczyk, Michael J.

doi:10.1172/jci106500

Cited by 120 publications

(31 citation statements)

References 8 publications

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“…Similar conclusions were derived from studies measuring serum Epo levels by bioassay in patients with anaemia secondary to chronic infection or malignancy including Hodgkin's and non-Hodgkin's lymphoma, multiple myeloma, and solid tumours (Dainiak et al, 1983;Ward et al, 1971). However, this was not observed in other studies of tumour-bearing rats (Zarrabi et al, 1977) and other investigations have found that human serum Epo levels were diminished relative to expected levels only in patients with infection and inflammation, but not in those with malignancies (Zucker et al, 1974).…”

Section: Discussionsupporting

confidence: 70%

Anaemia of lung cancer is due to impaired erythroid marrow response to erythropoietin stimulation as well as relative inadequacy of erythropoietin production

et al. 1997

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Summary. Many studies have been done in order to elucidate the pathogenesis of the anaemia of chronic disorders accompanying cancer, with conflicting results. This is probably due to the heterogeneity of the patient population selected for these studies (many patients treated by chemotherapy). To avoid this pitfall, in this study a very homogenous group of chemotherapy and radiotherapy-naive patients with lung cancer were selected. Serum erythropoietin and soluble transferrin receptor measurements suggested that the anaemia of non-treated lung cancer is mainly due to an impaired erythroid marrow response to erythropoietin stimulation. However, a relative inadequacy of erythropoietin production may also contribute.

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Section: Discussionsupporting

confidence: 70%

Anaemia of lung cancer is due to impaired erythroid marrow response to erythropoietin stimulation as well as relative inadequacy of erythropoietin production

et al. 1997

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“…In most other forms of anemia, as the hemoglobin is depressed below 9-10 g/100 ml, the level of plasma and urine erythropoietin are elevated in a roughly linear fashion (25). Ward, Kurnick, and Pisarczyk have noted significantly lower serum erythropoietin levels in anemia of infection and inflammation as compared to patients with iron deficiency or primary hematopoietic disease (26). Lower than expected levels of erythropoietin in the anemia of infection and inflammation were also noted in the present study.…”

Section: Discussionsupporting

confidence: 70%

“…Data on erythropoietin production in malignancy remains controversial. Ward et al and Firat and Banzon have noted no correlation between the erythropoietin levels and the degree of anemia in malignancy (26,28). Alexanian, on the other 'hand, has recently reported that urinary erythropoietin levels in human malignancy were appropriately elevated for the degree of anemia (29).…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Erythropoiesis in the Anemia of Infection, Inflammation, and Malignancy

Zucker¹,

Friedman²,

Lysik³

1974

J. Clin. Invest.

102

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A B S T R A C T A major factor in the anemia of infection, inflammation, and malignancy is a relative failure of the bone marrow to increase erythropoiesis in response to a shortened red cell survival. The possible causes for this diminished marrow response are: (a) a reduced production of erythropoietin, or, (b) impaired bone marrow response to erythropoietin. In this report studies were performed on 6 normals, 13 patients with anemia from infection or inflammation, and 18 patients with anemia caused by advanced malignancy. Serum erythropoietin activity was measured using the posthypoxic, polycythemic mouse assay. Assessment of bone marrow response to erythropoietin was made by measuring '9Fe-heme synthesis in bone marrow suspensions cultured for 3 days with and without the addition of erythropoietin. The results showed that marrow heme synthesis was increased in erythropoietin-treated cultures as compared with saline control cultures by 66± 8% (mean +SE) in normals, 101±10% in patients with infection or inflammation, and 31±5% in malignancy.Serum erythropoietin levels were consistently diminished relative to expected levels for the degree of anemia in the infection-inflammatory group, but not in malignancy.In these patients, plasma inhibitors to the biological activity of erythropoietin were not detected in vitro.These studies suggest that another factor to consider in the anemia of malignancy is a decreased bone marrow response to erythropoietin. In the anemia of infectioninflammation, marrow response to erythropoietin is normal, but serum levels of erythropoietin are decreased relative to the degree of anemia.

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“…The cause of this depression remains unclear however. Ward et al (1971) reported a decrease in plasma erythropoietin levels in patients with lymphoma, as well as in patients with chronic inflammation and infection. Zucker et at.…”

Section: Discussionmentioning

confidence: 99%

Erythropoiesis and iron metabolism in Hodgkin's disease

Al‐Ismail¹,

Cavill²,

Evans³

et al. 1979

Br J Cancer

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Summary.-Recently developed techniques for the investigation of iron kinetics were used to study the disturbance of iron metabolism in 19 untreated patients with Hodgkin's diseases (HD). The erythroid abnormality in newly diagnosed HD appears to be confined to those patients with systemic symptoms of weight loss, night sweats and fever, and consists of depression of marrow erythroid activity. These patients had a significantly lower haemoglobin and serum iron concentration and a higher serum ferritin concentration, both when compared to normal subjects and to those patients with HD who lacked systemic symptoms. Ineffective erythropoiesis and redcell destruction were not significantly increased. The present findings confirm that HD patients with systemic symptoms have a depression of erythropoiesis, and that in these patients the marrow fails to respond to the stimulus of mild anaemia.

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Serum level of erythropoietin in anemias associated with chronic infection, malignancy, and primary hematopoietic disease

Cited by 120 publications

References 8 publications

Anaemia of lung cancer is due to impaired erythroid marrow response to erythropoietin stimulation as well as relative inadequacy of erythropoietin production

Anaemia of lung cancer is due to impaired erythroid marrow response to erythropoietin stimulation as well as relative inadequacy of erythropoietin production

Bone Marrow Erythropoiesis in the Anemia of Infection, Inflammation, and Malignancy

Erythropoiesis and iron metabolism in Hodgkin's disease

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