Variable efficacy of recombinant human erythropoietin in anemic pregnant women with different forms of heterozygous hemoglobinopathy

Acta Haematol. 2006;116(4):259-65. doi: 10.1159/000095877.


Objective: The aim of this study was to determine the response to recombinant human erythropoietin (rhEPO) in anemic pregnant women with heterozygous hemoglobinopathies.

Methods: A prospective study including 19 consecutive pregnant women with anemia and heterozygous hemoglobinopathy was performed. Treatment was divided into two phases: the initial low-dose phase and the subsequent high-rhEPO phase. In the initial phase, 3 x 10,000 U of rhEPO was administered with intravenous iron sucrose. In patients showing a poor response (Hb increase <1 g/dl) to low-dose rhEPO, the rhEPO dose was increased to 20,000 U per treatment in the subsequent phase.

Results: All patients showed stimulation of erythropoiesis as evidenced by an increase in hemoglobin. In 13 patients, a good response to therapy was observed (mean Hb increase 1.6 +/- 0.5 g/dl). In 6 patients, resistance to rhEPO was noted (mean Hb increase 0.5 +/- 0.5 g/dl). The mean gestational age at the start of therapy was 28 weeks of gestation and at the end 32 weeks. The mean duration of a complete therapy was 3.5 weeks (range 2-4.5 weeks). If calculated for body weight, the initial low- rhEPO dose of 160.4 +/- 30.6 U/kg body weight/treatment was increased to 320.9 +/- 61.2 U/kg body weight/treatment in the subsequent phase.

Conclusion: Response to rhEPO treatment differs widely in anemic pregnant patients with heterozygous hemoglobinopathy. Resistance was observed in anemic pregnant patients with the beta-thalassemia trait originally from the Mediterranean region.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Anemia / drug therapy*
  • Anemia / etiology
  • Dose-Response Relationship, Drug
  • Erythropoietin / administration & dosage*
  • Female
  • Hemoglobinopathies / complications
  • Hemoglobinopathies / drug therapy
  • Hemoglobinopathies / genetics*
  • Heterozygote
  • Humans
  • Pregnancy
  • Pregnancy Complications, Hematologic / drug therapy
  • Pregnancy Complications, Hematologic / etiology
  • Pregnancy Complications, Hematologic / genetics
  • Recombinant Proteins
  • Treatment Outcome


  • Recombinant Proteins
  • Erythropoietin