Doctors Should Watch For Epoetin-Triggered Effect In Renal Failure

By Anne MacLennan

Patients with the anaemia of chronic renal failure can develop neutralizing antierythropoietin antibodies and pure red-cell aplasia during treatment with epoetin.

This is the finding of a multicentre study in France headed by Nicole Casadevall and colleagues from the Departments of Hematology and Nuclear Medicine, Hotel-Dieu, Paris.

An autoimmune response engendered by epoetin against endogenous erythropoietin is the most likely reason for the development of pure red-cell aplasia in these patients. Such a response should be considered in any patient being treated with epoetin in whom anaemia suddenly develops in the absence of the usual causes, these authors suggest.

Over a period of three years, this research team identified 13 patients, 12 in France and one in Britain, in whom pure red-cell aplasia developed during treatment with recombinant human erythropoietin (epoetin).

Study objective was to investigate there was an immunologic basis for the anaemia in the patients.

Researchers tested serum samples from the patients with pure red-cell aplasia for neutralizing antibodies that could inhibit erythroid-colony formation by normal bone marrow cells in vitro.

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