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Recombinant erythropoietin trial in children with transfusion-dependent homozygous beta-thalassemia
- Source :
- Acta haematologica. 98(4)
- Publication Year :
- 1997
-
Abstract
- Augmentation of gamma-gene synthesis by using recombinant human erythropoietin (r-Hu-EPO) represents a new approach to the therapy of beta-thalassemia. A prospective study was conducted in 26 transfusion-dependent beta-thalassemia major patients. r-Hu-EPO (Eprex/Cilag, Switzerland) was given to the patients at an initial dose of 500 IU/kg s.c. 3 times a week for at least 2 months during which no transfusion was applied. A sustained hemoglobin (Hb) level greater than 8 g/dl was considered as a response to EPO treatment. In the patients whose Hb levels remained under 8 g/dl or did not increase in comparison to pretreatment levels within 4 weeks, the dose of r-Hu-EPO was increased to 1,000 IU/kg 3 times a week and applied for another 4 weeks. Only 16 cases also received oral iron supplementation. The whole blood and reticulocyte counts, the biochemical tests including BUN, creatinine, AST, ALT, alkaline phosphatase and ferritin were done and the percentages of HbF and F cells were analyzed regularly. At the end of the 2nd month, 6 cases qualified to continue with the trial. At the end of the 6th month, r-Hu-EPO therapy was ceased in 3 cases of the 6 since their Hb levels had decreased below 7 g/dl. Only 3 cases (11.5%) continued with the r-Hu-EPO therapy without transfusion for up to 12 months. In conclusion, r-Hu-EPO may be useful in some selected transfusion-dependent patients with beta-thalassemia major. Selection criteria should include a mild beta-genotype of coinheritance of alpha-thalassemia, splenectomy and pretreatment reticulocyte response of the patients as well as the patients' compliance.
- Subjects :
- Hemolytic anemia
Adult
Male
Adolescent
Thalassemia
law.invention
Hemoglobins
law
hemic and lymphatic diseases
medicine
Humans
Prospective Studies
Prospective cohort study
Child
Erythropoietin
business.industry
beta-Thalassemia
Hematology
General Medicine
medicine.disease
Recombinant Proteins
Clinical trial
Hemoglobinopathy
Child, Preschool
Immunology
Recombinant DNA
Erythropoiesis
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 00015792
- Volume :
- 98
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Acta haematologica
- Accession number :
- edsair.doi.dedup.....e4d06cf383405e43b406eb5b6aa64a1a