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Repeated Blood Donations and Erythropoietin Levels

Paul V. Holland, MD
JAMA. 1989;261(10):1443-1444. doi:10.1001/jama.1989.03420100077021.
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To the Editor.—  The recent article by Drs Kickler and Spivak1 on the levels of erythropoietin following phlebotomy of autologous patient-donors was excellent. The findings nicely explain why such patients donating so frequently do not have a better marrow response to their frequent phlebotomy despite adequate iron stores or replacement. The study also provides a good basis for the potential use of erythropoietin in such individuals undergoing intensive phlebotomy to obtain units for potential blood loss at elective surgery.However, I would like to draw attention to one slight misinterpretation of the standards of the American Association of Blood Banks that is in the article. In the study of Drs Kickler and Spivak, it is stated that it is accepted standard practice to schedule donations at 3-day intervals. While this period between phlebotomies is acceptable, the standards actually state that the collection of autologous units "should not be undertaken

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