The influence of corticosteroids on human erythropoiesis. An in vivo study

Three groups of patients were studied to assess the effect of oral corticosteroid therapy on erythropoiesis in vivo as measured by changes in haemoglobin concentration (Hb) and red blood cell count (RBC). Fifteen patients with acute lymphoblastic leukaemia, who were in remission and receiving pulses of vincristine and prednisone during maintenance chemotherapy, showed no rise in Hb or RBC with steroid therapy. Likewise, 15 patients completing chemotherapy for ALL did not show a rise in Hb or RBC after stopping treatment. However, 14 children with acute immune thrombocytopenic purpura demonstrated a significant increase in Hb and RBC during a course of treatment with prednisone. These findings complement the results of in vitro studies, indicating that erythropoiesis in normal human bone marrow is stimulated by corticosteroid therapy.