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. 1970 Nov;49(11):1986–1992. doi: 10.1172/JCI106418

Erythropoiesis in the anemia of bone marrow failure

Raymond Alexanian 1,2, Clarence Alfrey 1,2
PMCID: PMC535776  PMID: 5475982

Abstract

The quantitative relationship between red cell volume, erythropoietin level, and erythropoiesis was evaluated in 43 human beings. Results in normal man were compared with studies in patients with anemia from bone marrow failure and with polycythemia vera. The maximum erythropoietin excretion after bleeding normal men was similar to the basal levels found in patients with chronic anemia of similar magnitude. Although erythropoietin values were low in patients with polycythemia vera, bleeding evoked a normal response. In patients anemic from bone marrow failure, basal levels were elevated, and phlebotomy resulted in an increase consistent with the new level of anemia. These observations indicate that erythropoietin level is affected primarily by the degree of anemia and is not influenced by the duration of anemia. In normal subjects, a fivefold increase in urinary erythropoietin was associated with a doubling of erythropoiesis. Despite similar degrees of erythropoietin production, anemic patients with evidence of bone marrow in the lower extremities had greater red cell production. In patients with polycythemia vera, red cell production was inappropriately elevated with regard to the urinary erythropoietin excretion. Bone marrow maturation time was not shortened in patients anemic from bone marrow failure to the same degree as in bled, normal volunteers. In addition to an adequate level of erythropoietin production, normal bone marrow function is necessary for maximal shortening of maturation time.

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1986

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adamson J. W. The erythropoietin-hematocrit relationship in normal and polycythemic man: implications of marrow regulation. Blood. 1968 Oct;32(4):597–609. [PubMed] [Google Scholar]
  2. Alexanian R. Correlations between erythropoietin production and excretion. J Lab Clin Med. 1969 Oct;74(4):614–622. [PubMed] [Google Scholar]
  3. Alexanian R., Vaughn W. K., Ruchelman M. W. Erythropoietin excretion in man following androgens. J Lab Clin Med. 1967 Nov;70(5):777–785. [PubMed] [Google Scholar]
  4. Alfrey C. P., Jr, Lynch E. C., Hettig R. A. Studies of iron kinetics using a linear scanner. I. Distribution of sites of uptake of plasma iron in hematological disorders. J Lab Clin Med. 1969 Mar;73(3):405–417. [PubMed] [Google Scholar]
  5. Cook J. D., Marsaglia G., Eschbach J. W., Funk D. D., Finch C. A. Ferrokinetics: a biologic model for plasma iron exchange in man. J Clin Invest. 1970 Feb;49(2):197–205. doi: 10.1172/JCI106228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. DONOHUE D. M., MOTULSKY A. G., GIBLETT E. R., PIRZIO-BIROLI G., VIRANUVATTI V., FINCH C. A. The use of chromium as red-cell tag. Br J Haematol. 1955 Jul;1(3):249–263. doi: 10.1111/j.1365-2141.1955.tb05508.x. [DOI] [PubMed] [Google Scholar]
  7. FUDENBERG H., BALDINI M., MAHONEY J. P., DAMESHEK W. The body hematocrit/venous hematocrit ratio and the "splenic reservoir". Blood. 1961 Jan;17:71–82. [PubMed] [Google Scholar]
  8. GIBLETT E. R., COLEMAN D. H., PIRZIOBIROLI G., DONOHUE D. M., MOTULSKY A. G., FINCH C. A. Erythrokinetics: quantitative measurements of red cell production and destruction in normal subjects and patients with anemia. Blood. 1956 Apr;11(4):291–309. [PubMed] [Google Scholar]
  9. HARTSOCK R. J., SMITH E. B., PETTY C. S. NORMAL VARIATIONS WITH AGING OF THE AMOUNT OF HEMATOPOIETIC TISSUE IN BONE MARROW FROM THE ANTERIOR ILIAC CREST. A STUDY MADE FROM 177 CASES OF SUDDEN DEATH EXAMINED BY NECROPSY. Am J Clin Pathol. 1965 Apr;43:326–331. doi: 10.1093/ajcp/43.4.326. [DOI] [PubMed] [Google Scholar]
  10. HASHIMOTO M. Pathology of bone marrow. Acta Haematol. 1962;27:193–216. doi: 10.1159/000206782. [DOI] [PubMed] [Google Scholar]
  11. Hammond D., Shore N., Movassaghi N. Production, utilization and excretion of erythropoietin. I. Chronic anemias. II. Aplastic crisis. 3. Erythropoietic effects of normal plasma. Ann N Y Acad Sci. 1968 Mar 29;149(1):516–527. doi: 10.1111/j.1749-6632.1968.tb15191.x. [DOI] [PubMed] [Google Scholar]
  12. Hillman R. S. Characteristics of marrow production and reticulocyte maturation in normal man in response to anemia. J Clin Invest. 1969 Mar;48(3):443–453. doi: 10.1172/JCI106001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hillman R. S., Henderson P. A. Control of marrow production by the level of iron supply. J Clin Invest. 1969 Mar;48(3):454–460. doi: 10.1172/JCI106002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Krantz S. B. Response of polycythemia vera marrow to erythropoietin in vitro. J Lab Clin Med. 1968 Jun;71(6):999–1012. [PubMed] [Google Scholar]
  15. VAN DYKE D. C., LAYRISSE M., LAWRENCE J. H., GARCIA J. F., POLLYCOVE M. Relation between severity of anemia and erythropoietin titer in human beings. Blood. 1961 Aug;18:187–201. [PubMed] [Google Scholar]
  16. VANDYKE D., ANGER H. O. PATTERNS OF MARROW HYPERTROPHY AND ATROPHY IN MAN. J Nucl Med. 1965 Feb;6:109–120. [PubMed] [Google Scholar]
  17. Van Dyke D., Nohr M. L., Lawrence J. H. Erythropoietin in the urine of normal and erythropoietically abnormal human beings. Blood. 1966 Oct;28(4):535–543. [PubMed] [Google Scholar]

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