Treatment of erythropoietin-resistant anaemia with desferrioxamine in patients on haemofiltration.
We studied 5 anaemic patients with Hb 74 +/- 8 g/l on haemofiltration (HF) treatment. They were iron overloaded. Their serum ferritin was 2667 +/- 8 micrograms/l. All patients' haemoglobin (Hb) levels decreased after an initial response to recombinant human erythropoietin (r-HuEPO) treatment. An increase in r-HuEPO dose from 100 to 400 U/kg s.c. thrice weekly with addition of oral and intravenous iron treatment for 8 weeks arrested the fall in Hb level. However, there was no significant increase in Hb during these 8 weeks. Iron was withdrawn at week 24 and desferrioxamine (DFO) treatment (i.v. doses of 2 g thrice weekly) was added to r-HuEPO from week 26 to 36. Two weeks after DFO initiation the Hb level increased to 110 g/l. Thereafter the r-HuEPO doses were reduced from 400 to 25 U/kg within 3 months. The Hb remained stable at a level of 110 g/l during the study, i.e., 17 months after the DFO treatment. Serum ferritin levels fell at a more rapid pace during DFO treatment and continued to decrease after DFO cessation for the following 17 months. In accordance with previous observations we found a positive effect of DFO treatment on erythropoiesis in patients with anaemia and iron overload. DFO treatment should be considered in patients with iron overload and r-HuEPO-resistant anaemia.
Goch
J
J
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Birgegård
G
G
Danielson
B G
BG
Wikström
B
B
D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy*; D003676:Deferoxamine / Q000627:therapeutic use*; D004351:Drug Resistance; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005293:Ferritins / Q000097:blood; D006440:Hemofiltration; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron; D003676:Deferoxamine