Bone marrow biopsy in uremic patients with erythropoietin therapy January 2009 – July 2012

Abstract

The aimed of this study is identified the BM changes that associated with (CRF), especially in those patients, treated with the recombinant erythropoietin and secondly how was the hematological response to erythropoietin itself. We followed 75 uremic patients whom were on (RDP) and were treated with a recombinant erythropoietin and supplemented by a parenteral iron because of symptomatic anemia, by bone marrow biopsy through anterior superior an iliac crest approach. All the specimens had been submitted to a histopathological examination by the same well certified pathologist. We found that 50 patients (66.66%) were males and 25 patients (33.33%) were females. Regarding the BM biopsy results 35 patients (46.66%) got (EH) 30 patients (40%) got normal cellular BM 10 patients (13.33%) got hypoplastic BM. There was no evidence of granuloma, carcinoma, sclerosis osteomalacia or osteoporosis in any of our patients. Regarding the response to erythropoietin, we found that most of our patients got a frequently symptomatic anemia and needed a blood transfusion irrespective of the regular (HD) that was supplemented by erythropoietin with a parenteral iron. We concluded that there was no specific BM changes that can be attributed to CRF. As far as the matter of erythrpoietin therapy was concerned, we found that most of our patients were still in a real need for a blood transfusion because of the symptomatic anemia irrespective of the erythropoietin administration in addition to parenteral iron. So we think that we must search for other modalities of therapy for the anemia in CRF in addition or an alternative to erythropoietin which had not reduced remarkably the need for the blood transfusion in our patients.

Keywords: Bone marrow (BM); Chronic renal failure (CRF); Hemodialysis (HD); Regular dialysis program (RDP); Erythroid hyperplasia (EH)