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rhEPO in hematopoietic stem cell mobilization, transplantation and in-vitro expansion

  • Sven Klaesson

Summary

Various hematopoietic growth factors and cytokines are being increasingly studied in the transplant setting. They are used, not only to accelerate haematopoietic recovery after cytopenias but also as mobilizers of stem cells in donors, ex vivo expansion of stem cells and for supportive treatment during infections. All these new factors, alone or in combination, may contribute to improved regimens during transplantation. Bone marrow transplant (BMT) or peripheral blood progenitor stem cells transplant (PBSCT) recipients have in the period following transplantation a frequent need for red blood cell transfusions and, therefore, an increased risk of blood-transmitted infections. The anemia is caused mainly by myelosuppression after high-dose chemotherapy but an impaired erythropoietin (EPO) production and an inappropriate EPO response may also contribute. Since recombinant human erythropoietin (rhEPO) has been established as a treatment for renal anemia it has been of interest whether treatment may be of benefit in the transplantation setting. So far data do not support any transfusional benefits with the use of rhEPO after autologous transplantation. In patients receiving an allograft, especially patients with immune hemolysis after transplantation, rhEPO treatment seems to accelerate erythroid engraftment, increase hemoglobin levels, reduce red blood cell transfusions and shorten time to transfusion independence. However, the optimal dose of rhEPO, the route of administration, the most effective combination with other hematopoietic growth factors, and in which patient populations cost-effective rhEPO therapy is justified are still open questions.

Keywords

Bone Marrow Transplant Allogeneic Bone Marrow Transplant Recombinant Human Erythropoietin Hematopoietic Growth Factor rhEPO Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag/Wien 2002

Authors and Affiliations

  1. 1.B57 Department of Pediatrics, Karolinska InstituteHuddinge University HospitalStockholmSweden

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