Abstract
In man, approximately 1% of the total red cell blood mass is produced each day in the bone marrow. This production rate is best reflected by emergence of reticulocytes in the bloodstream. An equal number of senescent red blood cells are removed from the circulation each day. This steady-state process maintains the hematocrit at an even level. When red blood cell production ceases entirely, the reticulocyte count drops to zero, and life-threatening anemia develops in approximately two months. Red blood cell transfusions provide short-term relief for this problem. However, due to the risks of hepatitis and iron overload, long-term red blood cell transfusion therapy is an unsatisfactory approach for the long-term treatment of patients with severe hypoproliferative anemias. See also p 723. During the last two decades, intensive research has provided a deeper understanding of the regulation of red blood cell production. Erythropoietin (EPO), a glycoprotein hormone produced by the
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