High-dose recombinant human erythropoietin stimulates reticulocyte production in patients with multiple organ dysfunction syndrome

Objective: To investigate erythropoietin (EPO) production and the erythropoietic potency of recombinant human EPO in the multiple organ dysfunction syndrome. Design: Randomized, prospective, controlled clinical trial. Materials and Methods: Patients received either 600 IU/kg intravenous EPO three times weekly (n = 9) or saline (control, n=10). Measurements: EPO levels, circulating soluble receptors for tumor necrosis factor and interleukin-2, levels of interleukin-6 and intercellular adhesion molecule, and early peripheral blood cell progenitors. Results: EPO production in the control group remained low. Pharmacologic EPO blood levels were associated with increased reticulocyte counts compared with both controls (p < 0.04) and baseline (p < 0.006), Increased levels of soluble receptors for tumor necrosis factor in the treatment group compared with the controls did not prevent this effect, Interleukin 6 inhibited reticulocyte production. Conclusion: Despite increased cytokine levels, pharmacologic EPO blood levels were associated with increased reticulocyte counts in patients with multiple organ dysfunction syndrome.