Is aranesp considered medically necessary for aplastic anemia?
Erythropoietin levels are elevated in apalstic anemia patients. This raises the probability that additional exogenous erythropoietin may not be effective. However, despite the same concern, erythropoietin is effective in in myelodysplastic syndrome. I reference a Japanese editorial that advocated the use of erythropoietin ( and this would include darbepoetin) for aplastic anemia.
However, there is very little supporting literature and no recommendations that are based on credible studies. Some experts do not support erytropoietin therapy in aplastic anemia. A noted authority, Dr. Jerry L. Spivak said this: “Myelofibrosis, leukemia, and aplastic anemia are other situations where erythropoietin therapy is usually ineffective, and when infection or inflammation is sufficiently severe, the response to erythropoietin will be blunted.”, at http://www.anemia.org/professionals/asktheexpert/treatment.jsp
However, there is very little supporting literature and no recommendations that are based on credible studies. Some experts do not support erytropoietin therapy in aplastic anemia at all, and t, to the extent, that the literature supports it, Procrit has been most commonly used. There is no literature based reason to use Aranesp over Procrit.
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Improvement of anemia by recombinant erythropoietin in patients with myelodysplastic syndromes and aplastic anemia International Journal of Cell Cloning, Vol 8, 445-458,
Phillip Scheinberg et al, How I treat acquired aplastic anemia. Blood. 2012 Aug 9; 120(6): 11851196.
Killick SB, Bown N, Cavenagh J, Dokal I, Foukaneli T, Hill A, et al. Guidelines for the diagnosis and management of adult aplastic anaemia. Br J Haematol. 2016 Jan. 172 (2):187-207