The authors declare they do not have any affiliation with industries or organizations with a financial interest, direct or indirect, that may affect the conduct or reporting of the work submitted.
Biological functions and therapeutic use of erythropoiesis-stimulating agents: perplexities and perspectives
Article first published online: 17 APR 2009
© 2009 Blackwell Publishing Ltd
British Journal of Haematology
Volume 146, Issue 2, pages 127–141, July 2009
How to Cite
Merchionne, F. and Dammacco, F. (2009), Biological functions and therapeutic use of erythropoiesis-stimulating agents: perplexities and perspectives. British Journal of Haematology, 146: 127–141. doi: 10.1111/j.1365-2141.2009.07702.x
- Issue published online: 1 JUL 2009
- Article first published online: 17 APR 2009
- erythropoietin receptor;
Randomized clinical studies, carried out in patients with haematological malignancies and with solid tumours, have consistently demonstrated that treatment with recombinant human erythropoietin (Epo) increases haemoglobin levels, reduces blood transfusion requirements, and improves the quality of life. In addition, identification of erythropoietin receptor (EpoR) expression on many types of non-erythroid and cancer cells has spurred an interest in the extra-haematological activities of Epo itself and other erythropoiesis-stimulating agents (ESAs). Epo and its derivatives have emerged as major tissue-protective cytokines in ischaemic and degenerative damage of cardiovascular, neurological and renal diseases, while their angiogenetic and immunomodulatory properties indicate that their therapeutic potential may extend well beyond erythropoiesis alone. Both preclinical and clinical data, however, have suggested that they may contribute to tumour progression and prejudice survival when administered to anaemic cancer patients, though the results are equivocal and the assumed mechanisms by which tumour growth could be promoted are not fully understood. While these findings offer new perspectives, they nonetheless demand caution in the employment of ESAs. Further, well-designed experimental and clinical studies are warranted.