On Jun 18, 10:24 am, "ironjust...@aol.com" <ironjust...@aol.com>
wrote:Aplastic anemia .. hemolysis .. fatigue <<

This could be retitled "How to produce aplastic anemia" ..

Ramping up red blood cell production causes apastic anemia.
Do too many red blood cells cause aplastic anemia?

Titre du document / Document title
Anti-erythropoietin antibody-mediated pure red cell aplasia after
treatment with recombinant erythropoietin products: Recommendations
for minimization of risk
Auteur(s) / Author(s)
COURNOYER Denis (1) ; TOFFELMIRE Edwin B. (2) ; WELLS George A. (3) ;
BARBER Dwayne L. (4) ; BARRETT Brendan J. (5) ; DELAGE Robert (6) ;
FORREST Donna L. (7) ; GAGNON Raymonde F. (8) ; HARVEY Elizabeth A.
(9) ; LANEUVILLE Pierre (10) ; PATTERSON Bruce J. (11) ; POON Man-Chiu
(12) ; POSEN Gerald A. (13) ; MESSNER Hans A. (11) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Departments of Medicine and Oncology, McGill University Health
Centre, Montreal, Quebec, ETATS-UNIS
(2) Departments of Medicine, and Pharmacology and Toxicology, Queen's
University, Kingston, Ontario, ETATS-UNIS
(3) Department of Epidemiology and Community Medicine, University of
Ottawa, Ottawa, Ontario, ETATS-UNIS
(4) Ontario Cancer Institute, Toronto, Ontario, ETATS-UNIS
(5) Division of Nephrology, Health Sciences Centre, St. John's,
Newfoundland, ETATS-UNIS
(6) Department of Hematology, CHAUQ, Laval University, Quebec, Quebec,
CANADA
(7) Department of Medicine, University of British Columbia, Vancouver,
British Columbia, CANADA
(8) Division of Nephrology, McGill University Health Centre, Montreal,
Quebec, ETATS-UNIS
(9) Division of Nephrology, Hospital for Sick Children, Toronto,
Ontario, ETATS-UNIS
(10) Division of Hematology, McGill University Health Centre,
Montreal, Quebec, ETATS-UNIS
(11) University Health Network, Princess Margaret Hospital, Toronto,
Ontario, ETATS-UNIS
(12) Department of Medicine, University of Calgary and Foothills
Hospital, Calgary, Alberta, ETATS-UNIS
(13) Division of Nephrology, The Ottawa Hospital, Ottawa, Ontario,
CANADA

Résumé / Abstract
Since 1998, there has been a marked increase in incidence of pure red
cell aplasia secondary to development of anti-erythropoietin
antibodies (Ab+ PRCA) in patients who have chronic kidney disease
(CKD) and receive recombinant erythropoietin. The relationship between
incidence of Ab+ PRCA and specific erythropoietin products has not
been examined rigorously. Manufacturers provided data regarding
exposure to erythropoietin products and incidence of Ab+ PRCA between
January 1998 and March 2003 in patients with CKD. Assuming a Poisson
distribution, a maximum likelihood estimate for the Poisson rate
parameter was calculated for each product. A test for homogeneity of
Poisson rates was conducted to compare likelihood estimates between
products. Global incidence of Ab+ PRCA was relatively low. Likelihood
estimates were not significantly different for Epogen, Procrit, and
Aranesp, independent of their formulation or route of administration.
Eprex lacking human serum albumin (HSA) and administered
subcutaneously was associated with the greatest risk of Ab+ PRCA. HSA-
containing Eprex administered subcutaneously was associated with a
lower risk than HSA-free Eprex administered subcutaneously, but this
risk exceeded that of intravenous Epogen and intravenous HSA-free
Eprex. NeoRecormon administered subcutaneously was associated with
less risk than subcutaneous HSA-free Eprex but more risk than
intravenous Epogen. HSA-free Eprex should not be administered
subcutaneously to patients with CKD due to increased risk of Ab+ PRCA.
Although the subcutaneous administration of HSA-containing Eprex is
riskier than intravenous Epogen and intravenous HSA-free Eprex, and
the use of subcutaneous NeoRecormon is riskier than intravenous
Epogen, there is currently no evidence that other products are safer.
Revue / Journal Title
Journal of the American Society of Nephrology   ISSN 1046-6673   CODEN
JASNEU
Source / Source
2004, vol. 15, no10, pp. 2728-2734 [7 page(s) (article)] (28 ref.)
Langue / Language
Anglais

Editeur / Publisher
Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS (1990)
(Revue)

Mots-clés anglais / English Keywords
Aplastic anemia ; Hemopathy ; Polypeptide ; Nephrology ;
Erythroblast ; Urology ; Risk ; Risk factor ; Recommendation ;
Product ; Treatment ; Antibody ; Erythropoietin ; Pure red cell
aplasia ;
Mots-clés français / French Keywords
Anémie aplasique ; Hémopathie ; Polypeptide ; Néphrologie ;
Erythroblaste ; Urologie ; Risque ; Facteur risque ; Recommandation ;
Produit ; Traitement ; Anticorps ; Erythropoïétine ;
Erythroblastopénie ;
Mots-clés espagnols / Spanish Keywords
Anemia aplástica ; Hemopatía ; Polipéptido ; Nefrología ;
Eritroblasto ; Urología ; Riesgo ; Factor riesgo ; Recomendación ;
Producto ; Tratamiento ; Anticuerpo ; Eritropoyetina ;
Eritroblastopenia ;
Localisation / Location
INIST-CNRS, Cote INIST : 26049, 35400012230448.0230

Copyright 2007 INIST-CNRS. All rights reserved

Toute reproduction ou diffusion même partielle, par quelque procédé ou
sur tout support que ce soit, ne pourra être faite sans l'accord
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or by any means, without the prior written permission of INIST-CNRS.

Nº notice refdoc (ud4) : 16146353

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