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Erythropoiesis and Carbon Monoxide Production in Hodgkin's Disease

Endogenous production of carbon monoxide (V co), red cell survival and iron kinetics were studied in 15 subjects with Hodgkin's disease. The subjects were divided into two groups, namely: eight patients with anaemia (group A, haemoglobin (Hb) concentration less than 11.5 g/dl) and seven patients without anaemia (group B, Hb concentration greater than 11.5 g/dl). Red cell survival was not significantly different in the two groups being 91 ± 40 days (mean± 1 SD) in group A and 111 ± 54 days in group B. Relative V co (μmol/mmol total body haem (TBH)/d) was, however, significantly higher (0.010.001) in group A (20.7±4.7) compared to group B (12.0±3.8). When absolute V co (μmol/d) was compared to the daily turnover of circulating red cell haemoglobin haem (V haem‐c), the V co/V haem‐c quotient was 2.1 ± 0.9 in group A and 1.2±0.3 in group B. Erythron turnover of iron (ET, μmol Fe/mmol TBH/d) was calculated through subtraction of the non‐erythron turnover (NET) from the total plasma iron turnover (PIT). ET was significantly higher (0.05>P>0.01) in group A (39±21) than in group B (20±8). The conclusion drawn from the finding of significant increases in V co and ET without any concomitant significant decrease in red cell survival in the anaemia group is that ineffective erythropoiesis, i. e. bone marrow haemolysis, seems to play an important role in the anaemia of Hodgkin's disease.