Re: Erythropoietin

From: art fougner, md (evsono@pipeline.com)
Sun Jan 25 11:25:25 2004


most reviews of EPO therapy involve its use as an adjunct to autologous donation. since acute hemorrhage is a powerful stimulus to erythropoetin production, would think that exogenous EPO might constitute gilding the lily so to speak. would favor iron therapy instead in this setting as others have described. there is a good review of the topic of "bloodless surgey" in the May 2003 issue of the journal Transfusion.

art

At Sun, 25 Jan 2004, Joanne Bulley, MD wrote: >
>My dad is on it for the anemia of renal failure. Pretty impressive
>response in that situation. It is like a factory with all the supplies
>piled up but the machine isn't turned on. When you give the
>erythropoietin in that situation, the marrow turns on (it is healthy -
>unlike the chemo patient) and the count starts risiing immediately.
>
>I have to agree with John - if she has healthy bone marrow - just suppor
>her with the QID iron - and don't forget folic acid and B12 - hopefully
>she isn't a vegetarian witn no iron or B12 in her diet!
>
>Joanne
>
>At Sun, 25 Jan 2004, Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.
>wrote:
>>
>>I have used it about a half dozen times mostly post op after ruptured
>>ectopics with HGB's in the 4's, seems to help slightly but still takes
>>them about a week to get back to 8 and I have had equally fast responses
>>with just ferrous gluconate 300 QID in young women with healthy marrow.
>>Most of the studies showing a good effect with erythropoietin are in
>>cancer and leukemia patients after chemotherapy, these patients are in a
>>catabolic state from malnutrition and
>>And chemo, there kidneys are probably not making a lot of erythropoietin
>>so the exogenous stuff probably helps them to a greater extent.
>>
>>--
>> Take care, John
>>
>--
>Joanne Bulley, MD
>Keene, NH, USA
>
>-----
>"It is easier to understand a nation by listening to
>its music than by learning its language" -Anonymous
>

--
art fougner, md
ich bin ein New Yorker




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