OBJECTIVETo detect serum erythropoietin (EPO) levels in patients with acute leukemia (AL) and iron deficient anemia (IDA) with moderate or severe anemia and explore the mechanism of anemia in these patients.

METHODSEnzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of EPO in 59 patients with AL, among whom 15 had complete remission without anemia and 44 had moderate or severe anemia (including 12 receiving the initial treatment, 13 with complete remission and concurrent anemia, and 19 with bone marrow suppression). Serum EPO was also detected in 15 IDA patients and 12 healthy individuals.

RESULTSThe IDA patients and healthy individuals had similar serum EPO levels (P>0.05), and by comparison, the EPO levels were significantly increased in AL patients upon the initial treatment, those with bone marrow suppression and those with complete remission and anemia, but comparable between the latter 3 groups (P>0.05). Among the patients with complete remission, the EPO levels were significantly higher in anemic patients than in those without anemia (P<0.05), and the latter patients had similar EPO levels with the healthy individuals (P>0.05). In both AL and IDA patients with moderate or severe anemia, the serum EPO level was inversely correlated to the level of hemoglobin (r=-0.697 and -0.970, respectively, P<0.05).

CONCLUSIONAL patients with anemia have significantly higher serum EPO levels than healthy individuals. In AL and IDA patients with moderate or severe anemia, EPO levels are inversely correlated to the level of hemoglobin, suggesting the integrity of the EPO synthesis mechanism in AL patients. Serum EPO level is also associated with bone marrow function in addition to hypoxia and hemoglobin levels, and hematopoiesis deficit in the early stage may be the main cause of anemia.