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  • Title: Resistance to recombinant human erythropoietin due to aluminium overload and its reversal by low dose desferrioxamine therapy.
    Author: Yaqoob M, Ahmad R, McClelland P, Shivakumar KA, Sallomi DF, Fahal IH, Roberts NB, Helliwell T.
    Journal: Postgrad Med J; 1993 Feb; 69(808):124-8. PubMed ID: 8506193.
    Abstract:
    Seventeen severely anaemic and transfusion-dependent haemodialysis patients with a haemoglobin less than 7 g/dl were treated with recombinant human erythropoietin (r-Hu-EPO). Aluminium toxicity was diagnosed by a positive desferrioxamine (DFO) test and bone biopsy. Seven out of eight patients without aluminium toxicity responded to r-Hu-EPO therapy. Similarly all patients with aluminium toxicity (n = 4) but pre-treated with standard dose of DFO prior to r-Hu-EPO therapy responded but none of the patients with untreated aluminium toxicity (n = 5) responded to r-Hu-EPO therapy. In order to achieve adequate response in these patients, r-Hu-EPO and DFO had to be given in combination. The dose of desferrioxamine used to reverse r-Hu-EPO resistance was less and also used for a short time. We therefore confirm r-Hu-EPO resistance owing to aluminium overload and report its successful and safe reversal with low dose DFO therapy.
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