Serum erythropoietin levels in children with leukemia

Dowd, Mph M. Denise; Morgan, Elaine; Langman, Craig B.; Murphy, Sharon B.

doi:10.1002/(sici)1096-911x(199704)28:4<259::aid-mpo4>3.0.co;2-h

Cited by 8 publications

(7 citation statements)

References 29 publications

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“…Anemia in children with cancer is associated with decreased erythropoietic activity but not with inadequate erythropoietin production, leading to the assumption that anemia in patients with leukemia mainly results from suppression of normal hematopoiesis in the bone marrow by infiltrating blasts. 5,6 To further understand the pathophysiology of anemia in childhood ALL, it is important to consider the heterogeneity of diseases in these patients, including immunological subgroups (precursor B-cell ALL versus T-cell leukemia) and cytogenetic subgroups (e.g. TEL-AML1, E2A-PBX1, BCR-ABL, hyperdiploid karyotype with >50 chromosomes, and MLL gene rearrangements).…”

Section: Introductionmentioning

confidence: 99%

Anemia and survival in childhood acute lymphoblastic leukemia

Teuffel¹,

Stanulla²,

Cario³

et al. 2008

Haematologica

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Section: Introductionmentioning

confidence: 99%

Anemia and survival in childhood acute lymphoblastic leukemia

Teuffel¹,

Stanulla²,

Cario³

et al. 2008

Haematologica

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“…This was interpreted as a relative EPO deficiency and led to the hypothesis that cancer patients might benefit from exogenous EPO [7][8][9].…”

Section: Discussionmentioning

confidence: 86%

“…The concept of using erythropoiesis-stimulating agents (ESAs) in treating and preventing chemotherapy-induced anemia (CIA) relies upon several research findings showing blunted serum EPO response to anemia in adult and pediatric cancer patients [6][7][8]. This was interpreted as a relative EPO deficiency and led to the hypothesis that cancer patients might benefit from exogenous EPO [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Single Dose Darbepoetin Alfa is Useful in Reducing Red Cell Transfusions in Leukemic Children Receiving Chemotherapy

Zachariah

Elshinawy²,

Al‐Rawas

et al. 2013

Pediatric Hematology and Oncology

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The role of erythropoiesis-stimulating agents (ESAs) in the management of chemotherapy-induced anemia (CIA) is becoming increasingly recognized in the field of medical oncology, with paucity of data in pediatrics. We evaluated the efficacy and tolerability of a single-dose darbepoetin alfa, a long-acting ESA, given to 35 pediatric acute lymphoblastic leukemia (ALL) children during induction chemotherapy. Compared to a retrospective control group, the studied patients have required significantly less units of packed red blood cells (0.88 units/patient in the studied group versus 2.04 units in controls), with no major side effects. We recommend further prospective double-blinded studies with more tailored dosing regimens in pediatric ALL cases and solid tumors.

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“…Inappropriate EPO production and/or impaired response of marrow to EPO have been suggested as mechanisms of anemia in cancer patients (20)(21)(22)(23)(24). Whether the EPO production in anemic cancer patients is appropriate and, if there is an inappropriate EPO production, whether the baseline serum EPO level can predict the effectiveness of rhEPO in the presence of inappropriate EPO production have been controversial (20)(21)(22)(23)(24)(25)(26). In our study, EPO increased significantly in response to the decrease of Hb in leukemia and solid tumor patients.…”

Section: Discussionmentioning

confidence: 99%

“…Since our study showed low sTfR and high EPO, the anemia in our cancer patients belongs to the former, coinciding with finding of Corraza et al (22). In spite of a significant inverse relationship between Hb and EPO, Dowd et al reported an inappropriately high or low EPO response to Hb in some cancer patients, suggesting a possibility of another control mechanism of EPO metabolism (23). Although the primary mechanism to control EPO is hypoxia due to low Hb, Cazzola et al showed that the serum level of EPO in reduced erythroid mass is higher than that in the normal erythroid mass for the same degree of low Hb.…”

Section: Discussionmentioning

confidence: 99%

Defective Erythropoiesis in Bone Marrow is a Mechanism of Anemia in Children with Cancer

Kim

Lee

et al. 2002

J Korean Med Sci

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Evaluation of the mechanism of anemia in cancer patients might help to select patients for the more efficient use of erythropoietin (EPO, a growth factor for erythroid precursor cells). For this, we investigated whether the production of EPO responds to anemia and the bone marrow responds to EPO appropriately, and whether chronic inflammation is inhibitory to erythropoiesis in anemic cancer children. Serum levels of EPO, soluble transferrin receptor (sTfR), tumor necrosis factor (TNF)-, and erythrocyte sedimentation rate (ESR) in anemic cancer children were measured by enzyme-linked immunosorbent assay and then the correlation coefficients between those parameters and hemoglobin (Hb) were determined. Both in leukemia and in solid tumor patients, there were significant inverse correlations between Hb and EPO (leukemia: tau=-0.547, p<0.0001; solid tumor: tau=-0.591, p<0.0001), and between sTfR and EPO (leukemia: tau=-0.223, p< 0.05; solid tumor: tau=-0.401, p<0.05). In contrast, sTfR showed a correlation with Hb in leukemia (tau=0.216, p<0.05) but not in solid tumor patients. sTfR was suppressed in 53% of anemic episodes of leukemia and 78% of those of solid tumor patients. Our results suggest that in cancer children, the EPO production is not defective and chronic inflammation is not inhibitory to erythropoiesis. Rather, the defective erythropoiesis itself is thought to be responsible for the anemia.

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Serum erythropoietin levels in children with leukemia

Cited by 8 publications

References 29 publications

Anemia and survival in childhood acute lymphoblastic leukemia

Anemia and survival in childhood acute lymphoblastic leukemia

Single Dose Darbepoetin Alfa is Useful in Reducing Red Cell Transfusions in Leukemic Children Receiving Chemotherapy

Defective Erythropoiesis in Bone Marrow is a Mechanism of Anemia in Children with Cancer

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