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Erythropoietin therapy versus red cell transfusion
1Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA. goodnough@labmed.wustl.edu
Current Opinion in Hematology
|October 18, 2001
Summary
Erythropoietin therapy offers an alternative to blood transfusions for medical and surgical anemia. Its adoption varies, influenced by transfusion risks, costs, and new blood-sparing techniques.
Area of Science:
- Hematology
- Transfusion Medicine
- Pharmacology
Background:
- Erythropoietin therapy approved for blood conservation in 1989 (medical anemia) and 1997 (surgical patients).
- Variable adoption rates observed across patient populations like renal failure, cancer, and surgical cases.
- Declining transfusion safety and rising costs increase interest in alternatives.
Purpose of the Study:
- To evaluate erythropoietin therapy as a blood conservation strategy.
- To examine the evolving landscape of blood transfusion alternatives.
- To consider new erythropoiesis-stimulating agents and techniques.
Main Methods:
- Review of erythropoietin therapy adoption trends.
- Analysis of blood transfusion risks, costs, and inventory.
- Assessment of emerging blood conservation techniques like acute normovolemic hemodilution (ANH) and novel erythropoiesis-stimulating proteins (NESP).
Main Results:
- Erythropoietin adoption has been rapid in some groups (renal failure) but slow in others (surgery).
- Transfusion risks have decreased, while costs have increased significantly.
- New methods like ANH and NESP offer additional transfusion alternatives.
Conclusions:
- Erythropoietin therapy, with or without autologous blood procurement, faces renewed scrutiny.
- Concerns about blood risks, inventory, and cost drive interest in erythropoietin.
- Evolving techniques provide new options beyond traditional blood transfusion.