Use of recombinant human erythropoietin after bone marrow transplantation in pediatric patients with acute leukemia: Effect on erythroid repopulation in autologous versus allogeneic transplants

F. Locatelli, M. Zecca, P. Pedrazzoli, L. Prete, S. Quaglini, P. Comoli, P. De Stefano, Y. Beguin, G. Robustelli della Cuna, F. Severi, M. Cazzola

Research output: Contribution to journalArticle

Abstract

We carried out a pilot study on the use of recombinant human erythropoietin (rHuEPO) in children undergoing allogeneic or mafosfamide-purged autologous BMT for ALL or AML. rHuEPO was administered intravenously at a dose of 75 U/kg/day for 30 days after transplant. Ten rHuEPO-treated patients receiving allogeneic BMT and 10 given autologous BMT were compared with 15 allogeneic and 10 autologous historical controls. Endogenous EPO production was appropriate for the degree of anemia after autologous BMT. In these patients, rHuEPO did not accelerate erythroid repopulation and did not modify transfusion requirements. With allogeneic BMT, erythroid marrow activity increased faster in patients given rHuEPO than in controls and resulted in higher red cell production, the mean reticulocyte count on day +30 being 187 ± 51 x 109/l in treated patients versus 107 ± 63 x 109/l in controls (p <0.01). The total number of RBC units administered was 1.7 ± 1.3 in the rHuEPO group versus 5.1 ± 3.0 in the control group (p <0.001). The total number of platelet transfusions was 4.0 ± 2.3 for patients given allogeneic BMT and receiving rHuEPO versus 8.4 ± 6.8 for historical controls (p <0.05) whereas it was similar in rHuEPO-treated and control autologous BMT patients. We conclude that (1) rHuEPO accelerates erythroid recovery and may reduce red cell and platelet transfusion requirements in children with acute leukemia given allogeneic BMT, (2) after mafosfamide-purged autologous BMT the development of erythropoiesis is mainly determined by the marrow proliferative capacity, and (3) due to the scarcity of committed progenitors, recipients of purged autologous BMT are unlikely to benefit from early administration of rHuEPO.

Original languageEnglish
Pages (from-to)403-410
Number of pages8
JournalBone Marrow Transplantation
Volume13
Issue number4
Publication statusPublished - 1994

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Erythropoietin
Bone Marrow Transplantation
Leukemia
Pediatrics
Transplants
Platelet Transfusion
Bone Marrow
Reticulocyte Count
Erythropoiesis
Anemia
Control Groups

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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title = "Use of recombinant human erythropoietin after bone marrow transplantation in pediatric patients with acute leukemia: Effect on erythroid repopulation in autologous versus allogeneic transplants",
abstract = "We carried out a pilot study on the use of recombinant human erythropoietin (rHuEPO) in children undergoing allogeneic or mafosfamide-purged autologous BMT for ALL or AML. rHuEPO was administered intravenously at a dose of 75 U/kg/day for 30 days after transplant. Ten rHuEPO-treated patients receiving allogeneic BMT and 10 given autologous BMT were compared with 15 allogeneic and 10 autologous historical controls. Endogenous EPO production was appropriate for the degree of anemia after autologous BMT. In these patients, rHuEPO did not accelerate erythroid repopulation and did not modify transfusion requirements. With allogeneic BMT, erythroid marrow activity increased faster in patients given rHuEPO than in controls and resulted in higher red cell production, the mean reticulocyte count on day +30 being 187 ± 51 x 109/l in treated patients versus 107 ± 63 x 109/l in controls (p <0.01). The total number of RBC units administered was 1.7 ± 1.3 in the rHuEPO group versus 5.1 ± 3.0 in the control group (p <0.001). The total number of platelet transfusions was 4.0 ± 2.3 for patients given allogeneic BMT and receiving rHuEPO versus 8.4 ± 6.8 for historical controls (p <0.05) whereas it was similar in rHuEPO-treated and control autologous BMT patients. We conclude that (1) rHuEPO accelerates erythroid recovery and may reduce red cell and platelet transfusion requirements in children with acute leukemia given allogeneic BMT, (2) after mafosfamide-purged autologous BMT the development of erythropoiesis is mainly determined by the marrow proliferative capacity, and (3) due to the scarcity of committed progenitors, recipients of purged autologous BMT are unlikely to benefit from early administration of rHuEPO.",
author = "F. Locatelli and M. Zecca and P. Pedrazzoli and L. Prete and S. Quaglini and P. Comoli and {De Stefano}, P. and Y. Beguin and {Robustelli della Cuna}, G. and F. Severi and M. Cazzola",
year = "1994",
language = "English",
volume = "13",
pages = "403--410",
journal = "Bone Marrow Transplantation",
issn = "0268-3369",
publisher = "Nature Publishing Group",
number = "4",

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TY - JOUR

T1 - Use of recombinant human erythropoietin after bone marrow transplantation in pediatric patients with acute leukemia

T2 - Effect on erythroid repopulation in autologous versus allogeneic transplants

AU - Locatelli, F.

AU - Zecca, M.

AU - Pedrazzoli, P.

AU - Prete, L.

AU - Quaglini, S.

AU - Comoli, P.

AU - De Stefano, P.

AU - Beguin, Y.

AU - Robustelli della Cuna, G.

AU - Severi, F.

AU - Cazzola, M.

PY - 1994

Y1 - 1994

N2 - We carried out a pilot study on the use of recombinant human erythropoietin (rHuEPO) in children undergoing allogeneic or mafosfamide-purged autologous BMT for ALL or AML. rHuEPO was administered intravenously at a dose of 75 U/kg/day for 30 days after transplant. Ten rHuEPO-treated patients receiving allogeneic BMT and 10 given autologous BMT were compared with 15 allogeneic and 10 autologous historical controls. Endogenous EPO production was appropriate for the degree of anemia after autologous BMT. In these patients, rHuEPO did not accelerate erythroid repopulation and did not modify transfusion requirements. With allogeneic BMT, erythroid marrow activity increased faster in patients given rHuEPO than in controls and resulted in higher red cell production, the mean reticulocyte count on day +30 being 187 ± 51 x 109/l in treated patients versus 107 ± 63 x 109/l in controls (p <0.01). The total number of RBC units administered was 1.7 ± 1.3 in the rHuEPO group versus 5.1 ± 3.0 in the control group (p <0.001). The total number of platelet transfusions was 4.0 ± 2.3 for patients given allogeneic BMT and receiving rHuEPO versus 8.4 ± 6.8 for historical controls (p <0.05) whereas it was similar in rHuEPO-treated and control autologous BMT patients. We conclude that (1) rHuEPO accelerates erythroid recovery and may reduce red cell and platelet transfusion requirements in children with acute leukemia given allogeneic BMT, (2) after mafosfamide-purged autologous BMT the development of erythropoiesis is mainly determined by the marrow proliferative capacity, and (3) due to the scarcity of committed progenitors, recipients of purged autologous BMT are unlikely to benefit from early administration of rHuEPO.

AB - We carried out a pilot study on the use of recombinant human erythropoietin (rHuEPO) in children undergoing allogeneic or mafosfamide-purged autologous BMT for ALL or AML. rHuEPO was administered intravenously at a dose of 75 U/kg/day for 30 days after transplant. Ten rHuEPO-treated patients receiving allogeneic BMT and 10 given autologous BMT were compared with 15 allogeneic and 10 autologous historical controls. Endogenous EPO production was appropriate for the degree of anemia after autologous BMT. In these patients, rHuEPO did not accelerate erythroid repopulation and did not modify transfusion requirements. With allogeneic BMT, erythroid marrow activity increased faster in patients given rHuEPO than in controls and resulted in higher red cell production, the mean reticulocyte count on day +30 being 187 ± 51 x 109/l in treated patients versus 107 ± 63 x 109/l in controls (p <0.01). The total number of RBC units administered was 1.7 ± 1.3 in the rHuEPO group versus 5.1 ± 3.0 in the control group (p <0.001). The total number of platelet transfusions was 4.0 ± 2.3 for patients given allogeneic BMT and receiving rHuEPO versus 8.4 ± 6.8 for historical controls (p <0.05) whereas it was similar in rHuEPO-treated and control autologous BMT patients. We conclude that (1) rHuEPO accelerates erythroid recovery and may reduce red cell and platelet transfusion requirements in children with acute leukemia given allogeneic BMT, (2) after mafosfamide-purged autologous BMT the development of erythropoiesis is mainly determined by the marrow proliferative capacity, and (3) due to the scarcity of committed progenitors, recipients of purged autologous BMT are unlikely to benefit from early administration of rHuEPO.

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