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Fetal hemoglobin in acute and chronic states of erythroid expansion
CA Blau, P Constantoulakis, A al-Khatti, E Spadaccino, E Goldwasser, T Papayannopoulou and G Stamatoyannopoulos
Division of Medical Oncology, University of Washington, Seattle.
Physiologic principles underlying the differences in fetal hemoglobin (HbF)
induction between acute and chronic states of erythroid expansion are
poorly understood. Whereas abrupt erythroid expansion is characterized by a
high proportion of reticulocytes coexpressing adult and fetal globin (F
reticulocytes), HbF levels wane with chronic erythropoietic stimulation. To
investigate this phenomenon, we used various schedules of erythropoietin
(epo) administration in primates. Acute intravenous epo administration
promoted a 2- to 10-fold preferential induction of F reticulocytes compared
with total reticulocytes. Total reticulocyte and F reticulocyte production
were significantly correlated (correlation coefficient .41 to .74). With
chronic epo administration, preferential F reticulocyte production was
lost, and there was no correlation between reticulocyte and F reticulocyte
production (correlation coefficient -.03). The mean percentage of F
reticulocytes did not change between acute and chronic schedules of epo
administration. The subcutaneous route of high-dose (3,000 U/kg) epo
administration was as effective as intravenous administration in the
induction of HbF. Reticulocyte and F reticulocyte responses to increasing
epo doses were found to be saturable. These results suggest that the
kinetics rather than absolute levels of reticulocyte and F reticulocyte
response form the basis for preferential F reticulocyte induction with
acute erythropoietic stimulation, and they support the hypothesis that F
reticulocytes arise from a relatively rapid pathway of erythroid
maturation.
Volume 81,
Issue 1,
pp. 227-233,
01/01/1993
Copyright © 1993 by The American Society of Hematology
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