title: Prospective randomised double-blind trial of the in vivo use of recombinant human erythropoietin in bone marrow transplantation from HLA-identical sibling donors. The Australian Bone Marrow Transplant Study Group.
abstract: Ninety one patients between the ages of 17 and 58 years undergoing histocompatible allogeneic transplants from sibling donors were entered into a double-blind randomised trial to evaluate the effect of human erythropoietin (rhu EPO) at a dose of 300 units per kg/day given thrice weekly by intravenous injection on erythropoiesis and on erythrocyte and platelet transfusion requirements. Dose was ceased when the haemoglobin exceeded 12g/dL and recommenced if the haemoglobin fell below 12 g/dL, at 150 units/kg/day. If the haemoglobin exceeded 12 g/dL on a further occasion, the dose of rhu EPO was not given. Patients received two units of erythrocytes when the haemoglobin dropped below 8.5g/dL and received platelet transfusions when the count dropped below 20 x 10(9)/L. Univariate analysis revealed a significantly higher reticulocyte count, haemoglobin concentration and bone marrow erythropoiesis after day 14 in the group receiving rhu EPO but this was not reflected in decreased erythrocyte transfusion (7 +/- 5 in controls versus 6 +/- 5 in rhu EPO group) or in platelet transfusions (11 +/- 7 in controls versus 11 +/- 9 in rhu EPO group). Hospitalisation in each group was the same (29 +/- 8 in the control group and 28 +/- 8 in the rhu EPO group). However, in the multivariate analysis, the administration of rhu EPO was associated with an 18% reduction in erythrocyte transfusion requirement when other variables were taken into account. No side-effects due to rhu EPO were detected in this study.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: St. Vincent's Hospital, Sydney, NSW, Australia.
authors.forename: J C
authors.initials: JC
authors.lastname: Biggs
authors.forename: K A
authors.initials: KA
authors.lastname: Atkinson
authors.forename: V
authors.initials: V
authors.lastname: Booker
authors.forename: A
authors.initials: A
authors.lastname: Concannon
authors.forename: G W
authors.initials: GW
authors.lastname: Dart
authors.forename: A
authors.initials: A
authors.lastname: Dodds
authors.forename: K
authors.initials: K
authors.lastname: Downs
authors.forename: J
authors.initials: J
authors.lastname: Szer
authors.forename: J
authors.initials: J
authors.lastname: Turner
authors.forename: R
authors.initials: R
authors.lastname: Worthington
mesh_terms: D000293:Adolescent; D000328:Adult; D001856:Bone Marrow Examination; D016026:Bone Marrow Transplantation; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion; D004921:Erythropoietin / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality; D006680:HLA Antigens / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy*; D009679:Nuclear Family; D017713:Platelet Transfusion; D011446:Prospective Studies
chemical_list: D006680:HLA Antigens; D006454:Hemoglobins; D004921:Erythropoietin