Relation between Erythropoiesis and Bone Metabolism in Thalassemia

THE anemia associated with thalassemia provokes a compensatory hyperplasia of the erythroid marrow, which in turn is associated with severe skeletal abnormalities. This study involved two previously splenectomized subjects with anemia and ineffective erythropoiesis. After basal measurements, the two patients were given transfusions to reduce erythropoietin stimulation of the erythroid marrow. This treatment provided an opportunity to evaluate the effect of suppression of erythropoiesis on bone metabolism.Ferrokinetic measurements and studies of erythropoiesis in marrow specimens indicated that rates were more than 10 times normal before transfusion. The bones were osteopenic, with decreased mineralized bone as well as increased osteoid. . . .