CLINICAL APPLICATION OF RECOMBINANT ERYTHROPOIETIN IN BETA-THALASSAEMIA INTERMEDIA

Research objective is to study the efficacy of recombinant erythropoietin (epoetin alfa) as alternative method of treatment beta-thalassemia intermedia. Study involved 58 patients with beta-thalassemia intermedia (23 women and 35 men). In all observed patients was defined levels of hemoglobin (Hb), red blood cells (RBC), erythrocyte indexes (MCV, MCH, MCHC), hemoglobin fractions (HbA, HbA2, HbF), serum ferritin, serum erythropoietin before and after administrated rEPO. All patients received rEPO during 6 month at the dose - 10000 IU subcutaneously. The majority of patients - 39 (67%) had a good response to rEPO (increase in hemoglobin level more than 20 g/l); 16 patients (28%) had a mean response (increase in Hb 10 - 20 g/l); in 3 (5%) patients occurred poor response to rEPO therapy (increase in Hb <10 g/l). After rEPO treatment of beta-thalassemia intermedia patients there was a statistically significant change in the number of RBC, levels of HbF and sEPO. The evaluation of interdependence between the indices of the baseline sEPO and increased Hb values in patients after rEPO treatment revealed the presence of the reverse direct relationship (r=-0.67). Based on the results, it can be concluded that the use of rEPO in complex therapy of beta-thalassemia intermedia leads to increased levels of Hb and consequently reducing the need for blood transfusions, and accordingly expected to prevent severe complications of blood transfusion (alloimmunization, hypersplenism, iron overload, contamination transmissible infections) facilitating normal growth and development, and a better quality of life.

Efficiency of recombinant erythropoietin administration in hemoglobinopathy H

Alpha-thalassemia is widely spread in human population and one of the most common types of α-thalassemia is hemoglobinopathy H which develops with mild microcytic hypochromic anemia, hepatosplenomegaly and jaundice. The basic method of anemia correction is blood transfusion. However this method has crucial deficiencies. As it is known recombinant erythropoetin (rEPO) contributes to erythroid proliferation and could be used for anemia treatment. The aim of the study was to qualify efficiency of administration rEPO in complex therapy of hemaglobinopathy H. Study involved irregularly transfused 14 patients with hemoglobinopathy H (2 males and 12 females). Control group included 30 healthy persons. Recombinant erythropoietin (Eprex) administrated hypodermically 10,000 units 3 times a week during 6 months. Average hemoglobin level before treatment was 62 g/l. Responses to the rEPO treatment varied from 9 to 70 g/l, 9 (64%) of patients had a good response, showed an increase in hemoglobin level more than 20 g/l. In 4 patients (29%) had a moderate response (10-20 g/l), but only in 1 (7%) patient occurred poor response. Changing the parameters of erithrocyte indices, hemoglobin fractions, serum iron and serum ferritin level are not statistically significant. It can be concluded that the use of rEPO in complex therapy of hemaglobinopathy H, leads to increased levels of hemoglobin and consequently reducing the need for blood transfusions.