What is pure red cell aplasia (PRCA)?
Pure red cell aplasia is caused by antibodies produced against an exogenous ESA cross-reacting with endogenous EPO.
This results in the complete loss of RBC precursors from the bone marrow and severe anemia. Most reported cases of PRCA have been associated with alterations of the ESA protein due to manufacturing, packaging, or distribution issues, and PRCA is almost exclusively associated with subcutaneous ESA administration.
Most patients with PRCA recover after withdrawal of the ESA and the use of immunosuppressive agents.
Pure red cell aplasia is very rare in industrialized countries with robust regulatory and pharmacovigilance systems.
