Bone marrow findings before and after treatment with recombinant human erythropoietin in chronic hemodialyzed patients.
The stimulating effect of rHuEPO on erythropoiesis has been shown in several studies, using bone marrow cell culture or animal models. To investigate the effect of rHuEPO on bone marrow findings in vivo, we studied the bone marrow cellularity, the myeloid: erythroid (M:E) ratio, an estimate of the number of megakaryocytes, any cytomorphologic or maturation abnormalities, and an estimate of the storage iron before and after 3 months of treatment with rHuEPO in 10 chronic hemodialyzed patients. Nine patients showed a slight or moderate decrease of erythropoiesis in bone marrow in comparison to normal bone marrow before rHuEPO treatment. The bone marrow cellularity was a mean of 28.5% and decreased in 8 out of 10 patients compared to normal values. However, megakaryopoiesis and granulopoiesis were normal. Three months of treatment with rHuEPO had increased erythropoiesis in all 10 patients, including one patient whose bone marrow proved to be normal erythropoiesis on baseline examination. The M:E ratio was significantly decreased from 4.0 +/- 1.2:1 to 2.4 +/- 1.1:1 (p < 0.005). The bone marrow cellularity was also increased in 9 patients, except in 1 patient whose specimen was inadequate for diagnosis, after 3 months of treatment with rHuEPO. On baseline examination of bone marrow, iron staining was undetectable in one, low in one, normal in 2 and high in 5 sections. According to grading, iron staining had decreased from 3.1 +/- 1.7 to 2.1 +/- 0.9 (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Ahn
J H
JH
Department of Internal Medicine, Kyung-Hee University Hospital, Seoul, Korea.
Yoon
K S
KS
Lee
W I
WI
Suh
J T
JT
Lee
T W
TW
Ihm
C G
CG
Kim
M J
MJ
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001853:Bone Marrow / Q000187:drug effects*; D001856:Bone Marrow Examination; D004920:Erythropoiesis / Q000187:drug effects*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000473:pathology / Q000628:therapy; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D006435:Renal Dialysis / Q000009:adverse effects
D011994:Recombinant Proteins; D004921:Erythropoietin