Recombinant erythropoietin in the prevention of late anaemia in intrauterine transfused neonates with Rh-haemolytic disease.
OBJECTIVE
To evaluate the efficacy of recombinant human erythropoietin (rHuEPO) in prevention of late anaemia due to Rh-haemolytic disease in neonates subjected to one or more intrauterine transfusions (IUTs).


METHODS
Six neonates (GA 28-38 weeks, BW 980-3,360 g), subjected to one or more IUTs for Rh-haemolytic disease, were treated for 3 weeks with rHuEPO (200 U/kg/day, s.c.) after the second week of life to prevent late anaemia and consequently reduce the need for blood transfusions. All treated neonates were supplemented weekly with iron, vitamin E and folinic acid, intramuscularly.


RESULTS
Of the 6 patients studied, 4 preterm neonates, after commencement of rHuEPO treatment, showed a decrease in Hct values with persistent reticulocytopenia, and consequent need for one or more transfusions with packed and filtered red cells (PFRC). These 4 neonates had received a greater blood volume with IUTs than the 2 other term neonates, who, after starting rHuEPO treatment, showed an increase in Hct values and in reticulocyte count, with no transfusion requirements after birth (247 +/- 47 vs. 84 +/- 76 ml).


CONCLUSIONS
Our results seem to correlate the efficacy of erythropoietin treatment in prevention of late anaemia resulting from Rh-haemolytic disease to the severity of intrauterine anaemia and to gestational age. Erythropoietin, in fact, was less effective in cases of severe intrauterine anaemia requiring a high volume of PFRC; it was also less effective in the preterm babies, because of the simultaneous presence of anaemia of prematurity and other major diseases.
Zuppa
A A
AA
Department of Neonatology, Catholic University of Sacred Heart, Rome, Italy.
Maragliano
G
G
Scapillati
M E
ME
Florio
M G
MG
Girlando
P
P
Noia
G
G
De Santis
M
M
Cavaliere
A F
AF
Romagnoli
C
C
Tortorolo
G
G
D000740:Anemia / Q000517:prevention & control*; D001805:Blood Transfusion, Intrauterine; D004899:Erythroblastosis, Fetal / Q000628:therapy*; D017707:Erythrocyte Transfusion; D004921:Erythropoietin / Q000627:therapeutic use*; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D017701:Reticulocyte Count / Q000187:drug effects; D019233:Retreatment; D012203:Rh Isoimmunization / Q000628:therapy*
D011994:Recombinant Proteins; D004921:Erythropoietin