Hematological Indices of Erythropoietin Administration in Athletes

Casoni, I.; Ricci, Giuseppe; Ballarín, Elena; Borsetto, C.; Grazzi, Giovanni; Guglielmini, C.; Manfredini, Fabio; Mazzoni, Gianni; Patracchini, M.; Vitali, E. De Paoli; Rigolin, F; Bartalotta, S.; Franze, Gian Pietro; Masotti, M.; Conconi, F

doi:10.1055/s-2007-1021183

Cited by 67 publications

(45 citation statements)

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“…Studies in athletes [26,27,28] have shown that erythropoietin administration increases work capacity, presumably by increasing the Hb concentration and thereby oxygen transport. Correction of anemia has been shown to improve QoL [29,30,31] and to reduce patient-reported fatigue [32,33,34].…”

Section: Discussionmentioning

confidence: 99%

Effect of Darbepoetin Alfa on Physical Function in Patients Undergoing Surgery for Colorectal Cancer

et al. 2006

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Objective: To study whether perioperative treatment with darbepoetin alfa (DA) improves physical performance following colorectal cancer surgery. Methods: Patients admitted for planned colorectal cancer surgery were randomized to receive either weekly placebo or DA 300 or 150 µg depending on the hemoglobin (Hb) concentration. Patients were assessed 10 days before, as well as 7 and 30 days after surgery for work capacity, postural sway, muscle strength, fatigue and quality of life (QoL). The primary outcome measure were the changes in patients’ physical performance from preoperative to postoperative day 7. Results: Of 221 included patients, 151 were evaluable. Baseline characteristics were similar in the 2 groups. Patients receiving DA had a significantly better working capacity on day 7 (p = 0.03) and day 30 (p = 0.03) compared with the placebo group. There were no statistically significant differences between the 2 groups on days 7 or 30 for fatigue, postural sway and QoL. DA treatment significantly (p < 0.01) reduced the decrease in Hb concentrations on day 7 and resulted in an earlier return (p < 0.01) to the preoperative Hb concentration compared to placebo treatment. Conclusion: Perioperative DA treatment improved postoperative work capacity and Hb concentrations, but had no effect on postoperative fatigue, postural sway, QoL and muscle strength.

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Section: Discussionmentioning

confidence: 99%

Effect of Darbepoetin Alfa on Physical Function in Patients Undergoing Surgery for Colorectal Cancer

et al. 2006

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“…Considering the dose (200 u kg−1) and the bioavail- 48,49]. However, after a single dose, Hb and Ht did not increase in spite of an increase in the numbers of ability of rHuEpo, a linear pharmacokinetic model was used to fit the data.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and pharmacodynamics of recombinant human erythropoietin in athletes. Blood sampling and doping control

Souillard

Audran

Bressolle

et al. 1996

Brit J Clinical Pharma

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1 The pharmacokinetics of recombinant human erythropoietin (rHuEpo) were initially determined in two healthy volunteers after a single subcutaneous dose (50 u kg−1). Twenty subjects then received repeated subcutaneous administrations of high dose ( 200 u kg−1) rHuEpo and 10 subjects received placebo. An immunoradiometric assay was used to measure the concentrations of erythropoietin (Epo) in serum and urine. 2 Serum Epo concentration-time profiles were best described by a onecompartment open model with zero-order input. The mean elimination halflife (±s.d.) was 42.0±34.2 h. Clearance, uncorrected for bioavailability, was 0.05±0.01 l h−1 kg−1. Erythropoietin concentrations returned to normal values in serum and urine, 7 and 4 days after the last administration, respectively. 3 The recombinant hormone was well tolerated. Significant changes in reticulocytes and red blood cells, haemoglobin concentrations and haematocrit were observed after administration of rHuEpo. In the control group, these parameters remained unchanged. 4 The change in reticulocytes was used as an index of the therapeutic effect of rHuEpo. The concentration-effect relationship was best described by an exponential model. 5 These data show the limitations of the measurement of Epo concentrations in blood and urine samples, collected in athletes during competition, for antidoping control. Epo doping can be detected only during or within 4 to 7 days of ending, a course of rHuEpo.

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“…114 The subcutaneous administration of rhEpo (ϳ 200 U/kg per week) and oral iron (270 mg/day) for 30 days produced an increase in Hct from 42.7 to 50.8, as well as in sTfR (from 3.1-6.3 mg/L) and the ratio between sTfR and ferritin (from 3.2-11.8). 13 Casoni et al 115 administered rhEpo subcutaneously at doses of 30 U/kg body weight every other day for 30-45 days to 20 subjects practicing sports at an amateur level. rhEpo treatment was accompanied by twice weekly administration of parenteral iron (62 mg intravenously) and oral vitamins.…”

Section: Rbc Parameters Associated With Esa Dopingmentioning

confidence: 99%

Blood doping and its detection

Jelkmann

Lundby

2011

Blood

128

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Hemoglobin mass is a key factor for maximal exercise capacity. Some athletes apply prohibited techniques and substances with intent to increase hemoglobin mass and physical performance, and this is often difficult to prove directly. Autologous red blood cell transfusion cannot be traced on reinfusion, and also recombinant erythropoietic proteins are detectable only within a certain timeframe. Novel erythropoietic substances, such as mimetics of erythropoietin (Epo) and activators of the Epo gene, may soon enter the sports scene. In addition, Epo gene transfer maneuvers are imaginable. Effective since December 2009, the World Anti-Doping Agency has therefore implemented “Athlete Biologic Passport Operating Guidelines,” which are based on the monitoring of several parameters for mature red blood cells and reticulocytes. Blood doping may be assumed, when these parameters change in a nonphysiologic way. Hematologists should be familiar with blood doping practices as they may play an important role in evaluating blood profiles of athletes with respect to manipulations, as contrasted with the established diagnosis of clinical disorders and genetic variations.

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Hematological Indices of Erythropoietin Administration in Athletes

Cited by 67 publications

References 2 publications

Effect of Darbepoetin Alfa on Physical Function in Patients Undergoing Surgery for Colorectal Cancer

Effect of Darbepoetin Alfa on Physical Function in Patients Undergoing Surgery for Colorectal Cancer

Pharmacokinetics and pharmacodynamics of recombinant human erythropoietin in athletes. Blood sampling and doping control

Blood doping and its detection

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