RSS Feeds
Predicting Response to Recombinant Human Erythropoietin
- Robert I. Abels, MD; and
- David H. Henry, MD
- The R.W. Johnson Pharmaceutical Research Institute; Raritan, NJ 08869 Graduate Hospital, Philadelphia, PA 19146
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 Unpublished letters cannot be returned.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.
IN RESPONSE:
In order to limit r-HuEPO therapy to patients most likely to respond, Drs. Mittelman and Floru suggest that it be restricted to patients with low serum erythropoietin levels. Although patients with low serum erythropoietin levels frequently respond more vigorously to r-HuEPO than do patients with higher levels, this is not always the case. In addition, it is often difficult to stipulate a serum erythropoietin level above which r-HuEPO therapy should be withheld.
Further analysis of our data [1] suggests that patients with serum erythropoietin levels between 100 and 500 IU/L had a response to r-HuEPO that was similar to that of patients whose serum erythropoietin levels were less than 100 IU/L (Table 1). Consequently, we continue to believe that in anemic patients with AIDS who are receiving zidovudine, a serum erythropoietin level 500 IU/L is a reasonably good predictor of response to r-HuEPO. However, it is not a value above which r-HuEPO is necessarily ineffective. We have not found a statistically significant relation between baseline erythropoietin levels and response to r-HuEPO in anemic patients with cancer who are receiving concomitant chemotherapy [2]. In addition, some patients with myelodysplasia who have serum EPO levels 500 IU/L may respond to pharmacologic doses of r-HuEPO [3].
We agree with Drs. Mittelman and Floru that it is important to try to limit r-HuEPO therapy to patients who are likely to respond. Although the predictive value of the baseline serum erythropoietin level in other anemic populations still must be defined, it may be prudent to avoid r-HuEPO therapy in patients with grossly elevated serum erythropoietin levels.
Robert I. Abels, MD
The R.W. Johnson Pharmaceutical Research Institute; Raritan, NJ 08869
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
