Studies of erythropoiesis and the discovery and cloning of recombinant human erythropoietin

Abstract

Patients who are anemic because of chronic kidney disease, cancer, arthritis, or chemotherapy or radiation therapy often report fatigue [1, 2, 3, 4, 5, 6]. Before the introduction of recombinant human erythropoietin (rHuEPO), anemia and its sequelae fatigue were treated with red blood cell transfusion, androgen stimulation of red blood cell production, and/or iron supplementation, among other treatments [7]. While effective in increasing red blood cell counts, both transfusions and androgen therapy have inherent risks [8]. Transfusions of red blood cells can be complicated by blood-borne pathogens, iron overload, immunologic consequences, and lack of or delayed hemoglobin response. Transfusions often improve but do not correct anemia and usually must be given frequently, and androgen therapy can cause viralization or abnormal liver function. rHuEPO is an ideal therapy because it mimics the action of the endogenous hormone by stimulating the production of red blood cells. Patients with chronic kidney disease are unable to produce adequate amounts of endogenous erythropoietin (EPO) to stimulate red blood cell production. Patients with cancer often have damaged bone marrow, with or without the insult of chemotherapy, that does not completely respond to the endogenous hormone.