[Clinical use of erythropoietin]

Humoral regulation of erythropoiesis has been known for 100 years, while clinical utilization of recombinant human erythropoietin (rhEPO) only for two decades. It can be said that there is much experience in regard to indications, models and results of its clinical utilization. According to the standpoint of secretion of erythropoietin, anemias can be divided into those where secretion is increased and satisfactory, those where it is increased but not satisfactory and into those where it is not increased or it is even decreased. Anemias of the first group are not an indication for rhEPO utilization, the second group is relative and the third group absolute indication for its utilization. The best results are achieved with absolute indications and it is anemia in chronic renal insufficiency and nonphysiologic anemia of premature babies. Good results can be expected, but not predicted in relative indications, such as anemias in chronic infections, anemias in malignant diseases, myelodysplastic syndrome, aplastic anemia and other secondary anemias. Utilization of rhEPO is useful also in certain states without anemia, especially in transfusiology.