Serum Erythropoietin Levels in Children with Acute Lymphoblastic Leukemia and Solid Tumor

Woo, Chan Wook; Lee, Jung Hwa; Lee, Kwang Chul; Kim, Soon Kyum

Abstract

PURPOSE: The necessity of recombinant human erythropoietin (rhEpo) as a therapeutic agent in pediatric cancer patients has been challenged. Before clinical trials of the rhEpo, we evaluated the relationship of endogenous eythropoietin (Epo) level and hemoglobin (Hgb) in childhood acute lymphoblastic leukemia (ALL) and solid tumors.
METHODS
Twenty eight children (20 ALL and 8 solid tumor) were involved in this study in Korea University Medical Center from January 1999 to June 1999. Epo and Hgb were measured simultaneously several times in the course of their diseases, and a simple regression analysis was performed to describe the Epo-Hgb relationship.
RESULTS
1) There was no inverse linear relationship between Log10Epo (LogEpo) and the variable Hgb of the control group (n=7). 2) There was a significant inverse linear relationship between LogEpo and the variable Hgb at the induction and consolidation phase of the childhood ALL patients (n=14) (r=0.73, P<0.05). 3) There was a significant inverse linear relationship between LogEpo and the variable Hgb at the reinduction phase of the childhood ALL patients (n=15) (r= 0.72, P<0.05). 4) There was a significant inverse linear relationship between LogEpo and the variable Hgb at the maintenance phase of the childhood ALL patients (n=19) (r= 0.74, P<0.05). 5) There was a significant inverse linear relationship between LogEpo and the variable Hgb during the chemotherapy of the childhood solid tumors patients (n=15) (r= 0.76, P<0.05).
CONCLUSION
There was a significant inverse relationship between Epo and Hgb in pediatric cancer patients, suggesting that the negative feedback mechanism for endogenous production of Epo is intact.