Abstract
In the 1980s, recombinant human erythropoietin (rhEPO) began to be used in clinical practice. In this study, the clinical application of rhEPO from single-center in recent ten years was reviewed, and the scope of indications and clinical efficacy were evaluated. The medical records of 35829 in-patients who were treated with rhEPO in the first Medical Center of the Chinese PLA General Hospital from 2009 to 2018 were collected. According to the scope of indications approved by CFDA (China Food and Drug Administration), curative effect and off-label of rhEPO were analyzed. Of the 35829 patients, 19013 (53.1%) were male and 16816 (46.9%) were female, with an average age of (52.1 ± 18.6) years. The usage of rhEPO is increasing year by year. The overall effective rate was 53.1%. The number of patients who met the indications accounted for 67.2%, and the effective rate patients with indications and Off-label were 48.8% and 50.7%. Among the patients with irregular use of rhEPO perioperative imperfect laboratory examination patients accounted for the highest proportion (7.1%). The volume of RBC(s) (red blood cell(s)) transfusion in patients with rhEPO was significantly less than that in patients without rhEPO (p<0.05). The use of rhEPO Off-label is very common and has a certain curative effect. It can be used as evidence support for the update of the scope of indications. In addition, There are still irregular use of rhEPO and transfusion in clinic. The unreasonable use of rhEPO and transfusion should be further standardized to ensure the safety and effectiveness.
Highlights
Erythropoietin (EPO) is an active glycoprotein secreted by the kidney
From January 2009 to December 2018, the patients of anemia caused by renal failure, anemia caused by chemotherapy for nonbone marrow malignant tumors, RBCs mobilization during recombinant human erythropoietin (rhEPO) Use in a Clinical perioperative period, according to whether or not to use rhEPO at the same time, they were divided into two groups to compare RBCs transfusion volume. rhEPO medication can significantly reduce RBCs transfusion in patients with anemia caused by renal failure and anemia caused by chemotherapy for non-bone marrow malignant tumors
The highest proportion of drug use was anemia caused by renal failure, followed by preoperative erythrocyte mobilization and anemia caused by chemotherapy for non-bone marrow malignant tumors (Figure 2)
Summary
Erythropoietin (EPO) is an active glycoprotein secreted by the kidney. EPO in blood binds to EPO receptors on the surface of erythroid hematopoietic progenitor cells in bone marrow, which can promote the proliferation and differentiation of erythroid hematopoietic progenitor cells. The maternal RBCs progenitor cells could stimulate the colony formation obviously. At high rhEPO Use in a Clinical concentration, it could stimulate the early maternal RBCs progenitor cells and guide the colony formation (Kuhrt and Wojchowski, 2015). EPO is an effective apoptosis regulator, which can resist apoptosis by maintaining the stability of mitochondrial membrane, up-regulating the expression of bcl and bcl-xl genes and inhibiting the activation of caspase-3. It can delay the apoptosis of erythroid progenitor cells, primitive erythrocytes and a series of hematopoietic cells (Jaspers et al, 2014). The two mechanisms work together to keep the number of mature RBC(s) relatively stable in normal people, increase the number of RBC(s) and the concentration of hemoglobin in anemia patients, and directly improve the oxygen carrying capacity of blood
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
