Brunati C, Cappellini M D, De Feo T, Stefanoni I, Civati G, Ballerini L, Fiorelli G, Minetti L
Divisione Nefrologia e Dialisi, Ospedale Niguarda Cà Granda, Italia.
Nephron. 1992;62(2):150-4. doi: 10.1159/000187024.
The dose of recombinant human erythropoietin (r-HuEpo) required to correct anemia of end-stage renal disease varies among patients. The possible factors that interfere with the responsiveness to r-HuEpo were not completely known. In 32 patients on regular hemodialytic treatment with marked anemia (Hb 5.6 +/- 0.7 g/dl), we evaluated circulating erythroid progenitor cells [burst-forming-unit erythroid (BFU-E)], erythropoietin, ferritin, folate and 1-84-parathormone levels before r-HuEpo therapy. In 12 patients, the aluminum levels after deferoxamine were also evaluated. The possible correlation between these factors and the response to r-HuEpo therapy was then evaluated. The number of circulating (c) BFU-E was highly variable (521 +/- 447 colonies/ml of blood; normal level 742 +/- 192) and does not correlate with erythropoietin, ferritin, folate, 1-84-parathormone or aluminum levels. A direct correlation between basal cBFU-E and the responsiveness to r-HuEpo therapy was recorded while no correlation was found with the other analyzed parameters. We hypothesized that low basal cBFU-E (interleukin-3 deficiency?) could reduce the response to r-HUEpo because of failure of this hematopoietic stem cell compartment to replenish the pool of more mature erythropoietic progenitor cells during the phase of accelerated maturation induced by r-HuEpo.
纠正终末期肾病贫血所需的重组人促红细胞生成素（r-HuEpo）剂量在患者之间存在差异。干扰对r-HuEpo反应性的可能因素尚不完全清楚。在32例接受规律血液透析治疗且伴有明显贫血（血红蛋白5.6±0.7 g/dl）的患者中，我们在r-HuEpo治疗前评估了循环红系祖细胞[红系爆式集落形成单位（BFU-E）]、促红细胞生成素、铁蛋白、叶酸和1-84甲状旁腺激素水平。在12例患者中，还评估了去铁胺治疗后的铝水平。然后评估这些因素与r-HuEpo治疗反应之间的可能相关性。循环（c）BFU-E的数量变化很大（521±447个集落/ml血液；正常水平742±192），且与促红细胞生成素、铁蛋白、叶酸、1-84甲状旁腺激素或铝水平无关。记录到基础cBFU-E与r-HuEpo治疗反应之间存在直接相关性，而与其他分析参数未发现相关性。我们推测，基础cBFU-E水平低（白细胞介素-3缺乏？）可能会降低对r-HUEpo的反应，因为在r-HuEpo诱导的加速成熟阶段，这个造血干细胞区室无法补充更成熟的红系祖细胞池。
