ISSN 2997-1036
International Journal of Hematology | Vol. 8, No. 7, July 2017 | pp. 49–56
DOI: 10.46882/2017/IJH/000091
Original Article
Title: Evaluation of absolute immature reticulocyte fraction and plasma erythropoietin variants in response to recombinant human erythropoietin in aplastic anemia
Names of Authors: A. I. Ibrahim¹, C. D. Balogun², E. O. Ojo³
Authors’ Affiliations: ¹Department of Haematology, Ahmadu Bello University, Zaria, Nigeria; ²Department of Medicine, University of Ilorin, Ilorin, Nigeria; ³Department of Chemical Pathology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
Abstract: Recombinant human erythropoietin therapy may benefit a subset of aplastic anemia patients, but pre-treatment kinetic predictors remain poorly defined. This prospective clinical study evaluated baseline plasma endogenous erythropoietin concentrations and absolute immature reticulocyte fraction (IRF) variations in 35 patients with moderate aplastic anemia receiving high-dose recombinant human erythropoietin therapy (10,000 IU subcutaneously three times weekly) over a 24-week period. Full blood counts were monitored bi-weekly, and clinical response was defined as transfusion independence or a stable hemoglobin increase exceeding 2.0 g/dl. Erythroid response was achieved in 34.2% (12 of 35) of the patients. Responders demonstrated a significantly lower baseline endogenous erythropoietin level (mean 142.5 ± 24.5 mIU/ml) compared to non-responders (mean 850.4 ± 112.0 mIU/ml, P < 0.001), reflecting a less saturated bone marrow feedback loop. Following 4 weeks of intervention, responsive patients displayed a distinct spike in the immature reticulocyte fraction from a baseline of 0.04 ± 0.01 to 0.18 ± 0.03 (P < 0.01). Quantifying baseline endogenous erythropoietin coupled with early immature reticulocyte tracking provides an affordable, predictive diagnostic framework for identifying aplastic anemia cohorts likely to benefit from growth factor regimens.
Keywords: Aplastic anemia, recombinant erythropoietin, immature reticulocyte fraction, bone marrow failure, erythropoiesis
Manuscript Timeline: Received: April 14, 2017; Revised: May 20, 2017; Accepted: June 08, 2017; Published: July 15, 2017