Reactions 1372 - 8 Oct 2011

SDarbepoetin-α/epoetin-αPure red cell aplasia and an elderly patient: casereport

A 70-year-old man developed pure red cell aplasiafollowing treatment with epoetin-α and darbepoetin-α[therapeutic indication not clearly stated].

In May 2008, the man started haemodialysis for chronicrenal failure. IV epoetin-α 3000IU three times weekly wasadministered for 2 months; this was later switched to IVdarbepoetin-α 30 µg/week. In August, his haemoglobinlevels started to decline. Darbepoetin-α was increased to90µg/week, but his anaemia continued to worsen; hebecame transfusion-dependent by January 2009.Laboratory tests showed normocytic-normochromicanaemia with low reticulocyte count. Bone marrowaspiration biopsy revealed severe reduction inerythropoiesis, with no dysplasia and a normal karyotype.Pure red cell aplasia was confirmed in March. Epoetin-αantibodies were detected by radioimmune precipitationassay.

Darbepoetin-α was discontinued and ciclosporin wasinitiated. The man’s epoetin-α antibody titres graduallydecreased over the following months, and his reticulocytecount recovered. His haemoglobin levels have remained at>8 g/dL since, and he has not required transfusions.Shimizu H, et al. Pure red cell aplasia induced only by intravenous administrationof recombinant human erythropoietin. Acta Haematologica 126: 114-118, No. 2,Aug 2011. Available from: URL: http://dx.doi.org/10.1159/000328041 -Japan 803061031

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Reactions 8 Oct 2011 No. 13720114-9954/10/1372-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved