Erythropoiesis, iron metabolism and iron supplementation during erythropoietin therapy


Recent knowledge gained regarding the relationship between erythropoietin, iron, and erythropoiesis in patients with anemia undergoing recombinant human erythropoietin therapy (EPO) has implications for clinical management of oncology patients. During EPO therapy, iron restricted erythropoiesis is evident even in the presence of storage iron and oral iron supplementation. Intravenous iron therapy in renal dialysis patients undergoing EPO therapy can produce hematological responses in patients with serum ferritin levels up to 400μgL, indicating that traditional biochemical markers of storage iron in patients with anemia of chronic disease have limitations in assessment of iron status. Newer measurements of erythrocyte and reticulocyte indices using automated counters show promise in the evaluation of iron restricted erythropoiesis. The availability of safer intravenous iron preparations allows for carefully controlled studies of their value in oncology patients undergoing EPO therapy. This chapter will provide an overview of these emerging issues, along with future directions for clinical research.


Serum Ferritin Transferrin Saturation Recombinant Human Erythropoietin Intravenous Iron Iron Dextran 
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© Springer-Verlag/Wien 2002

Authors and Affiliations

  1. 1.Departments of Medicine and Pathology and ImmunologyWashington University School of MedicineSt. LouisUSA

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