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A. Kagan, MD, Division of Nephrology, Kaplan Hospital, Rehovot, 76100 (Israel) Dear Sir, Recently, Steinberg [1] reported the successful use of recombinant human erythropoietin in the treatment of 2 patients with sickle cell anemia and renal failure. We have used erythropoietin therapy for severe anemia in 2 siblings with ß thalassemia minor and end-stage renal failure, in whom a unique association of hereditary nephritis and ep-idermolysis bullosa was previously reported [2]. The hematological characteristics of the patients and their response to treatment are shown in figure 1. Blood transfusion requirements for 6 months prior to therapy were 14 blood units for R.Y., a 21-year-old male, and 12 blood units for I.Y., his 19-year-old sister. In the first 4 months following initiation of erythropoietin treatment, R.Y. required 7 units and I. Y. 5 units; thereafter, blood transfusions were not needed. No problems with vascular access or increase in blood pressure were observed. Maintenance doses of erythropoietin in 15 other adult patients on dialysis are shown in table 1. These doses in the 2 siblings were higher than those required in the other 6 patients with ß thalassemia trait, probably due to the differences in the ß globin synthesis. ß Thalassemia is characterized by a decreased amount of ß globin as well as typically

Recombinant Human Erythropoietin for Anemia of End-Stage Renal Failure in Beta Thalassemia Trait