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In the past few years several cases of pure red-cell aplasia (PRCA) associated with neutralizing antierythropoietin antibodies emerging during epoetin treatment have been reported [1–6]. The majority of the cases have occurred in Europe and have been associated with subcutaneous administration of epoetin alfa [4,7,9,10]. There are very few reports from theUSA. The epoetin alfa preparations used in USA are different from those used in Europe [7,10]. Discontinuation of epoetin therapy as well as immunosuppressive treatment have been used to treat the condition. We report two patients who developed PRCA during subcutaneous epoetin alfa therapy. After discontinuation of epoetin alfa, both patients were successfully treated with other epoetins followed by a good response in erythropoiesis and without any signs of allergic reactions.

Two haemodialysis patients with epoetin alfa-induced pure red-cell aplasia recovered despite treatment with another epoetin preparation