Variable efficacy of recombinant human erythropoietin in anemic pregnant women with different forms of heterozygous hemoglobinopathy.

Abstract

OBJECTIVE:

The aim of this study was to determine the response to recombinant human erythropoietin (rhEPO) in anemic pregnant women with heterozygous hemoglobinopathies.

METHODS:

A prospective study including 19 consecutive pregnant women with anemia and heterozygous hemoglobinopathy was performed. Treatment was divided into two phases: the initial low-dose phase and the subsequent high-rhEPO phase. In the initial phase, 3 x 10,000 U of rhEPO was administered with intravenous iron sucrose. In patients showing a poor response (Hb increase <1 g/dl) to low-dose rhEPO, the rhEPO dose was increased to 20,000 U per treatment in the subsequent phase.

RESULTS:

All patients showed stimulation of erythropoiesis as evidenced by an increase in hemoglobin. In 13 patients, a good response to therapy was observed (mean Hb increase 1.6 +/- 0.5 g/dl). In 6 patients, resistance to rhEPO was noted (mean Hb increase 0.5 +/- 0.5 g/dl). The mean gestational age at the start of therapy was 28 weeks of gestation and at the end 32 weeks. The mean duration of a complete therapy was 3.5 weeks (range 2-4.5 weeks). If calculated for body weight, the initial low- rhEPO dose of 160.4 +/- 30.6 U/kg body weight/treatment was increased to 320.9 +/- 61.2 U/kg body weight/treatment in the subsequent phase.

CONCLUSION:

Response to rhEPO treatment differs widely in anemic pregnant patients with heterozygous hemoglobinopathy. Resistance was observed in anemic pregnant patients with the beta-thalassemia trait originally from the Mediterranean region.

• Authors: Gabriela Bencaiova, Alexander Krafft, Tilo Burkhardt, Christian Breymann
• Journal: Acta haematologica (Acta Haematol) Vol. 116 Issue 4 Pg. 259-65 ( 2006) ISSN: 0001-5792 [Print] Switzerland
• PMID: 17119327 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright 2006 S. Karger AG, Basel.

Chemical References

• Recombinant Proteins
• Erythropoietin

Topics

• Adult
• Anemia (drug therapy, etiology)
• Dose-Response Relationship, Drug
• Erythropoietin (administration & dosage)
• Female
• Hemoglobinopathies (complications, drug therapy, genetics)
• Heterozygote
• Humans
• Pregnancy
• Pregnancy Complications, Hematologic (drug therapy, etiology, genetics)
• Recombinant Proteins
• Treatment Outcome