Increased iron absorption during autologous blood donation supported by recombinant human erythropoietin therapy.
BACKGROUND
Recombinant human erythropoietin (rHuEPO) therapy improves the success of autologous blood (AB) donation programs before elective surgery. The aim of this study was to evaluate iron absorption during an AB donation program with or without rHuEPO.


METHODS
Thirty-two patients were randomly assigned among placebo (Group 1) or 300 (Group 2) or 600 UI per kg rHuEPO (Group 3) on the first, second, and third donation visits. All patients also received daily oral iron (200 mg Fe(+)).


RESULTS
The number of units collected in Group 3 was higher than in Group 1 (4.6 +/- 0.5 vs. 3.6 +/- 0.8 units; p < 0.01). Red blood cell (RBC) production increased in a rHuEPO dose-dependent manner. With rHuEPO, the RBC volume collected per unit presented a lower decrease with number of donated units than with placebo and was similar to that of homologous blood units. Storage iron did not influence the number of units collected, whereas circulating mobilizable iron was the limiting factor. Oral iron absorption increased in a rHuEPO dose-dependent manner (12-fold with 600 UI/kg rHuEPO) and was proportional to erythropoietic activity.


CONCLUSIONS
rHuEPO does not only improve the number of AB units collected but also their quality. Storage iron cannot meet marrow iron requirements, but rHuEPO strongly increased oral iron absorption in a dose-dependent fashion through stimulation of erythropoietic activity.
Bovy
Christophe
C
Department of Nephrology, Center of Genic and Cellular Therapy, CHU Sart-Tilman, Liège, Belgium. cbovy@yahoo.com
Baudoux
Etienne
E
Salmon
Jean Pol
JP
Beguin
Yves
Y
D000328:Adult; D000368:Aged; D001804:Blood Transfusion, Autologous / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D004906:Erythrocyte Count; D004912:Erythrocytes / Q000187:drug effects; D004920:Erythropoiesis / Q000187:drug effects; D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use
D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron