Comparative effects of cyclophosphamide and total body irradiation on erythropoietin production in rats

Changes in serum erythropoietin levels during allogeneic bone marrow transplantation

Serial serum erythropoietin levels were measured in 10 consecutive patients undergoing allogeneic bone marrow transplantation. Observed erythropoietin levels are compared with those predicted from a large control population of anaemic patients not receiving chemotherapy. There was an initial acute rise in serum erythropoietin, peaking between days 1 and 4 after marrow transfusion, which was unrelated to changes in haemoglobin concentration. Patients maintained serum erythropoietin concentrations at around twice the predicted level for the first 2 weeks following transplantation, with a gradual fall into the expected range by wk 3. Erythropoietin levels did not change with episodes of bacterial infection or acute graft-versus-host disease. A patient with severe aplastic anaemia had initial successful engraftment with normalisation of erythropoietin levels, but showed a marked and amplified rise in erythropoietin 2 wk before falling peripheral blood counts indicated failure of the bone marrow graft.

On radiation damage to normal tissues and its treatment. I. Growth factors

The first part of the review outlines the classical interpretation of radiation damage to normal organs based on dose-response relationships for clonogenic cell survival and tissue kinetics. Proliferative organization of critical cell lineages (three-compartmental or H-type and one-compartmental or F-type) is considered as an additional determinant in the development of overt radiation injury. This leads to testable predictions concerned with divergent outcomes of stimulation of cell proliferation after radiation exposure using polypeptide growth factors. The prediction of favourable effects of such stimulation in H-type lineages is borne out by recent experiments on treatment with cytokines of radiation-induced haemopoietic insufficiency. The second prediction of deleterious effects of proliferative stimulation in recently, heavily irradiated F-type cell lineages remains to be verified or refuted.

Inappropriate increase in erythropoietin titers during chemotherapy

Serial erythropoietin measurements by RIA were performed in six patients with acute leukemia treated by intensive chemotherapy. In all cases erythropoietin titers increased after the onset of treatment, although the hemoglobin concentration remained at stable values. Subsequently the erythropoietin titers gradually returned to baseline levels. In same patients this reduction occurred at the end of chemotherapy, in others coincident with infections and antibiotic therapy. In four patients this decrease occurred at the time of bone marrow recovery. The explanation for this inappropriate increase in erythropoietin titers is not clear but may be related to a direct or indirect effect of a suppressed marrow on sites of erythropoietin production or catabolism.

Experimental Study of the Relationships between Activation of Erythropoiesis and Hematotoxicity of Some Antitumoral Agents

The changes in the blood toxicity of some antitumoral chemotherapeutic agents in the presence of erythropoiesis activation by bleeding are evaluated. The general toxicity seems to be unaffected but the damage to erythropoiesis proved, in absolute terms, to be more severe in the bled animals. The recovery of hematopoiesis was slower after some drugs than others. These results are discussed in the light of present knowledge of hematopoietic kinetics and of the relationships between antiblastic drugs and stamina] hematopoietic compartments.