Recombinant human erythropoietin in anemia of prematurity.
OBJECTIVE
To evaluate safety and efficacy of recombinant human erythropoietin (r-HuEPO)in reducing the need for red cell transfusions in anemia of prematurity.


METHODS
forty -two preterm infants (gestational age <32 weeks) were randomly assigned to a "treatment" group (r-HuEPO 400 units/kg every alternate day * 10 doses) or "no treatment" (control) group. All infants on enteral feeds received oral iron 3 mg/kg/day, graded up to 6 mg/kg/day.


RESULTS
Higher reticulocyte counts in week 2 and 3 and higher hemoglobin levels in week 4 were noted after treatment with r-HuEPO. Despite stumulated erythropoiesis, the frequency of transfusions could not be reduced with r-HuEPO therapy.Overall, Phlebotomy losses, frequency and volume of redcell transfusions were significantly more in neonates with birthweight <1000 grams compared with those with birthweight >1000 grams (p<0.05). Associated side effects of r-HuEPO such as neutropenia,sepsis, hypertension or increased risk of late death did not occur.


CONCLUSIONS
r-HuEPO therapy was safe without any side effects. Inability of r-HuEPO therapy to minimize red cell transfusions for anemia of prematurity may be explained by a relatively strict red-cell transfusion policy and the desired degree of treatment effect.
Whitehall
J S
JS
Department of Neonatology, Kirwan Hospital for Woman, QLD 4817, Australia.
Patole
S K
SK
Campbell
P
P
D000284:Administration, Oral; D000740:Anemia / Q000188:drug therapy* / Q000628:therapy; D001724:Birth Weight; D004750:Enteral Nutrition; D004906:Erythrocyte Count; D017707:Erythrocyte Transfusion; D004920:Erythropoiesis / Q000187:drug effects; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000517:prevention & control / Q000628:therapy; D019102:Infant, Very Low Birth Weight; D007501:Iron / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D009503:Neutropenia / Q000517:prevention & control; D018962:Phlebotomy / Q000009:adverse effects; D011994:Recombinant Proteins; D012156:Reticulocytes / Q000473:pathology; D012449:Safety; D018805:Sepsis / Q000517:prevention & control; D015996:Survival Rate
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron