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Predicting Response to Recombinant Human Erythropoietin
- Moshe Mittelman, MD; and
- Sharon Floru, MD
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TO THE EDITOR:
We read with interest the recent article by Henry and colleagues [1], summarizing four clinical trials of recombinant human erythropoietin (r-HuEPO). They conclude that therapy with r-HuEPO can increase the mean hematocrit value and decrease the mean transfusion requirement in anemic patients with the acquired immunodeficiency syndrome (AIDS) who are receiving zidovudine and have low endogenous erythropoietin levels (<500 IU/L).
Given the expanding indications for and the high price of r-HuEPO therapy, predicting the response to therapy is important. Response to r-HuEPO appears not to be related to age, gender, time since diagnosis, time since initiation of transfusion therapy, or changes in plasma transferrin receptor protein concentrations [2, 3].
We administered r-HuEPO therapy to seven anemic patients who had stem cell disorders with r-HuEPO and concluded that the pretreatment serum erythropoietin level was a good predictor of response [4]; other findings support this conclusion [5]. It also seems possible to use a lower pretreatment serum erythropoietin level (approximately 200 IU/L) as the cutoff point.
Thus, we believe that Henry and colleagues' data can be extended to other candidates for r-HuEPO therapy.
Moshe Mittleman, MD
Sharon Floru, MD
Hasharon Hospital, Tel Aviv University; Petah-Tikva 49372, Israel
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright 2004 by the American College of Physicians
