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Recombinant Human Erythropoietin (rhEPO) in Clinical Oncology pp 407–431Cite as

Pharmacology, pharmacokinetics and safety of recombinant human erythropoietin preparations

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Abstract

Hematocrit, blood hemoglobin concentration and red cell mass are regulated by the glycoprotein hormone erythropoietin (EPO).The degree of tissue oxygenation is the primary determinant of the expression of the EPO gene in the kidney. Other production sites contribute little to circulating EPO in humans after birth, albeit the liver is the main site of EPO mRNA expression in fetuses. EPO inhibits the programmed cell death (apoptosis) of the erythrocytic progenitors in the bone marrow, and it stimulates their proliferation and differentiation. Lack of EPO results in normochromic normocytic anemia. The physical power of anemic persons is reduced. Anemia can lead to fatigue, pallor, shortness of breath, tachycardia and angina pectoris due to tissue hypoxia. In severe cases allogeneic red cell transfusion may be required, although there is no clear threshold hemoglobin concentration for intervention. The decision to transfuse is usually based on the severity of the clinical symptoms of hypoxia, and on the patient’s age and co-morbidity. The transfusion of allogeneic blood components is associated with the risk of immunologic reactions and of bacterial or viral infection. In addition, repeated red blood cell transfusions can lead to iron overload. Therefore, the introduction of recombinant human erythropoietin (rhEPO) as an anti-anemic drug for stimulation of erythropoiesis has represented a major therapeutic step in medicine.

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  1. Institute of Physiology, Medical University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany

    Prof. Dr. Wolfgang Jelkmann M.D. (Director, Professor of Physiology)

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  1. Prof. Dr. Wolfgang Jelkmann M.D.
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  1. Department of Internal Medicine (Cancer Research), West German Cancer Center, University Hospital of Essen, Essen, Germany

    Mohammad Resa Nowrousian

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Jelkmann, W. (2008). Pharmacology, pharmacokinetics and safety of recombinant human erythropoietin preparations. In: Nowrousian, M.R. (eds) Recombinant Human Erythropoietin (rhEPO) in Clinical Oncology. Springer, Vienna. https://doi.org/10.1007/978-3-211-69459-6_16

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