110 SERUM TRANSFERRIN RECEPTOR (TfR) AND ERYTHROPOIETIN (Epo) AS INDICATORS OF ERYTHROPOIESIS IN CHILDREN WITH NEWLY DIAGNOSED ACUTE LYMPHOBLASTIC LEUKEMIA (ALL)

摘要

The initial depression of erythropoiesis followed by a rapid stimulation of erythropoiesis in children with newly diagnosed ALL may serve as a model to study TfR and Epo as indicators of erythropoiesis. We studied weekly the blood hemoglobin and reticulocyte counts, TfR and Epo from 35 children with newly diagnosed ALL during 12 weeks from diagnosis. The mean age of the patients was 6.1 years. The patients were treated according to the Scandinavian ALL protocols. Serum TfR and Epo concentrations were measured by IFMA (Pediatr Res 1993;34:297) and EIA methods, respectively. The mean weekly TfR concentrations were 2.8 ±0.2 mg/1 (SEM) at diagnosis. They gradually decreased to 2.1 ±0.2 mg/1 at 3 weeks. Thisafter, the values increased and reached the maximal level at 8 weeks (4.9 ±0.5 mg/1). The pattern of the mean values for reticulocyte counts was similar; 1.3 ± 0.2% at diagnosis, 0.3 ±0.05% at 2 weeks and 4.7 ±1.3% at 8 weeks. In contrast, Epo levels were elevated and behaved differently. The mean value was 330 IU/L at diagnosis. After the therapy started the values gradually decreased by week 5 and remained stable thereafter (mean values 79-111 IU/L). Under these conditions we conclude that 1) TfR level reflects the rate of erythropoiesis, and 2) TfR level is undependent on the Epo levels.