Current markers of the Athlete Blood Passport do not flag microdose EPO doping

Abstract

The Athlete Blood Passport is the most recent tool adopted by anti-doping authorities to detect athletes using performance-enhancing drugs such as recombinant human erythropoietin (rhEPO). This strategy relies on detecting abnormal variations in haematological variables caused by doping, against a background of biological and analytical variability. Ten subjects were given twice weekly intravenous injections of rhEPO for up to 12 weeks. Full blood counts were measured using a Sysmex XE-2100 automated haematology analyser, and total haemoglobin mass via a carbon monoxide rebreathing test. The sensitivity of the passport to flag abnormal deviations in blood values was evaluated using dedicated Athlete Blood Passport software. Our treatment regimen elicited a 10% increase in total haemoglobin mass equivalent to approximately two bags of reinfused blood. The passport software did not flag any subjects as being suspicious of doping whilst they were receiving rhEPO. We conclude that it is possible for athletes to use rhEPO without eliciting abnormal changes in the blood variables currently monitored by the Athlete Blood Passport.

Evaluation of the MAIIA dipstick test to detect recombinant human erythropoietin in plasma

“…Injections of rhEPO (Neorecormon, Roche Diagnostics, Australia) were given intravenously twice per week (Monday & Thursday). The incremental microdose treatment has been described previously [7] where dosages began at 10 IU/kg then increased to 20, 30 and finally 40 IU/kg in some subjects by the conclusion of the study. Blood samples (K 3 EDTA) from which plasma was obtained were also collected Monday and Thursday but always prior to rhEPO injections.…”

Hepcidin as a new biomarker for detecting autologous blood transfusion

“…The ABP haematological module uses blood markers such as haemoglobin (Hb) concentration and reticulocyte percentage to detect doping with erythropoiesis-stimulating agents (ESAs) and blood transfusion [6]. However, the shift towards "micro-dose" injection of ESAs and blood transfusion has made it difficult to detect such doping by using the haematological module [7,8]. There is thus a need for new markers that can be integrated into the ABP to further enhance the detection of blood transfusion.…”

Sports doping: Racing just to keep up

“…"There are still chinks in the armour, " says Catlin. A team led by Michael Ashenden, an anti-doping researcher who heads the Science and Industry Against Blood Doping consortium in Gold Coast, Australia, simulated EPO 'microdosing' in ten volunteers 1 . They received small intravenous injections twice weekly for 12 weeks.…”