Randolph John E, Scarlett Janet, Stokol Tracy, MacLeod James N
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
J Vet Intern Med. 2004 Jan-Feb;18(1):81-91. doi: 10.1892/0891-6640(2004)18<81:ceasor>2.0.co;2.
The efficacy and safety of recombinant canine erythropoietin (rcEPO) therapy was evaluated in 19 dogs with anemia of chronic renal failure (group 1) and 6 dogs with chronic renal failure and recombinant human erythropoietin (rhEPO)-induced red cell aplasia (group 2). Hematocrit (Hct) and absolute reticulocyte count (ARC) were monitored weekly for the first 8 weeks, CBC (including ARC) and serum iron profiles were evaluated monthly, and serum biochemical analyses were performed every 2 months for 6 (group 2) to 12 (group 1) months. For group 1 dogs, median Hct and ARC increased significantly during the 1st week of rcEPO treatment, and median Hct was sustained at >35% after week 5. In contrast, median Hct and ARC for group 2 did not change significantly with rcEPO treatment, even with doses greater than those used in group 1. Nevertheless, 2 (33%) of the 6 dogs in group 2 developed erythroid hyperplasia, reticulocytosis, and increases in Hct with rcEPO treatment. Although median systolic blood pressure did not change significantly in either group, 5 dogs developed systolic blood pressures > or = 180 mm Hg during the study. Appetite and energy level improved in most group 1 dogs with increases in Hct. Recombinant cEPO stimulated erythrocyte production in dogs with nonregenerative anemia secondary to chronic renal failure without causing the profound erythroid hypoplasia that can occur in rhEPO-treated dogs. Unfortunately, rcEPO was not as effective in restoring erythrocyte production in dogs that had previously developed rhEPO-induced red cell aplasia.
对19只患有慢性肾衰竭贫血的犬(第1组)和6只患有慢性肾衰竭且出现重组人促红细胞生成素(rhEPO)诱导的红细胞再生障碍的犬(第2组)进行了重组犬促红细胞生成素(rcEPO)治疗的疗效和安全性评估。在最初的8周内每周监测血细胞比容(Hct)和绝对网织红细胞计数(ARC),每月评估全血细胞计数(包括ARC)和血清铁指标,每2个月进行一次血清生化分析,持续6个月(第2组)至12个月(第1组)。对于第1组犬,rcEPO治疗第1周时Hct和ARC中位数显著增加,第5周后Hct中位数维持在>35%。相比之下,第2组犬使用rcEPO治疗时,即使剂量高于第1组,Hct和ARC中位数也没有显著变化。然而,第2组的6只犬中有2只(33%)在rcEPO治疗后出现了红系增生、网织红细胞增多和Hct升高。尽管两组的收缩压中位数均无显著变化,但研究期间有5只犬的收缩压≥180 mmHg。随着Hct升高,大多数第1组犬的食欲和能量水平有所改善。重组cEPO刺激了慢性肾衰竭继发的非再生性贫血犬的红细胞生成,且未引起rhEPO治疗犬可能出现的严重红系发育不全。不幸的是,rcEPO在恢复先前出现rhEPO诱导的红细胞再生障碍犬的红细胞生成方面效果不佳。