Does recombinant human erythropoietin accelerate correction of post-ulcer-bleeding anaemia?A pilot study

AIM:Anaemia caused by acute upper gastrointestinalbleeding is treated with blood transfusion or iron,but patientsusually face a two-month recovery period from post-haemorrhage anaemia.This prospective,randomised,open,pilot study was designed to investigate whether recombinanthuman erythropoietin(Epoetin)therapy acceleratehaematocrit increase in the post-bleeding recovery period.METHODS:We studied hospitalised patients admittedbecause of acute ulcer bleeding or haemorrhagic gastritis,who had a haematocrit of 27-33% and did not receive bloodtransfusions.One day after the endoscopic confirmation ofcessation of bleeding,they were randomised either toerythropoietin(20 000 IU Epoetin alfa subcutaneously,ondays 0,4 and 6)plus iron(100 mg im,on days 1-6,(G1)oriron only(G2).Haematocdt was measured on days 0,6,14,30,45,and 60,respectively.RESULTS:One patient from G1and two from G2were lost tofollow-up.Therefore,14 and 13 patients from G1and G2respectively were analysed.Demographic characteristics,serumiron,ferritin,total iron binding capacity,reticulocytes,andhaernatoait were not significantly different at entry to the study.Median reticulocyte counts were significantly different betweengroups on day six(G1:4.0,3.0-6.4 vs G2:3.5,2.1-4.4%,P=0.03)and median haematocrit on day fourteen [G1:35.9,30.7-41.0 vs G2:32.5,29.5-37.0%(median,range),P=0.04].CONCLUSION:Erythropoietin administration significantlyaccelerates correction of anemia after acute ulcer bleeding.The haematocrit gain is equivalent to one unit of transfusedblood two weeks after the bleeding episode.