title: Early treatment with erythropoietin beta ameliorates anemia and reduces transfusion requirements in infants with birth weights below 1000 g.
abstract: OBJECTIVE
  To investigate whether recombinant erythropoietin (rhEPO) reduces the need for transfusion in extremely low birth weight (ELBW) infants (birth weight 500-999 g) and to determine the optimal time for treatment.
  
  
  METHODS
  In a blinded multicenter trial, 219 ELBW infants were randomized on day 3 to one of 3 groups: early rhEPO group (rhEPO from the first week for 9 weeks, n = 74), late rhEPO group (rhEPO from the fourth week for 6 weeks, n = 74), or control group (no rhEPO, n = 71). All infants received enteral iron (3-9 mg/kg/day) from the first week. The rhEPO beta dose was 750 IU/kg/week. Success was defined as no transfusion and hematocrit levels never below 30%.
  
  
  RESULTS
  Success rate was 13% in the early rhEPO group, 11% in the late rhEPO group, and 4% in the control group (P =.026 for early rhEPO versus control group). Median transfusion volume was 0.4 versus 0.5 versus 0.7 mL/kg/day (P =.02) and median donor exposure was 1.0 versus 1.0 versus 2.0 (P =.05) in the early rhEPO group, the late rhEPO group, and the control group, respectively. Infection risk was not increased and weight gain was not delayed with rhEPO beta.
  
  
  CONCLUSIONS
  Early rhEPO beta treatment effectively reduces the need for transfusion in ELBW infants.
authors.forename: Rolf F
authors.initials: RF
authors.lastname: Maier
authors.forename: Michael
authors.initials: M
authors.lastname: Obladen
authors.forename: Ingo
authors.initials: I
authors.lastname: Müller-Hansen
authors.forename: Evelyn
authors.initials: E
authors.lastname: Kattner
authors.forename: Ulrich
authors.initials: U
authors.lastname: Merz
authors.forename: Romaine
authors.initials: R
authors.lastname: Arlettaz
authors.forename: Peter
authors.initials: P
authors.lastname: Groneck
authors.forename: Hannes
authors.initials: H
authors.lastname: Hammer
authors.forename: Hans
authors.initials: H
authors.lastname: Kössel
authors.forename: Gaston
authors.initials: G
authors.lastname: Verellen
authors.forename: Gerd-Jürgen
authors.initials: GJ
authors.lastname: Stock
authors.forename: Thierry
authors.initials: T
authors.lastname: Lacaze-Masmonteil
authors.forename: Olivier
authors.initials: O
authors.lastname: Claris
authors.forename: Martin
authors.initials: M
authors.lastname: Wagner
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Matis
authors.forename: Frank
authors.initials: F
authors.lastname: Gilberg
mesh_terms: D000751:Anemia, Neonatal / Q000188:drug therapy* / Q000401:mortality; D001803:Blood Transfusion; D003428:Cross Infection / Q000453:epidemiology; D004311:Double-Blind Method; D004921:Erythropoietin / Q000627:therapeutic use*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007501:Iron / Q000378:metabolism / Q000627:therapeutic use; D008297:Male; D016016:Proportional Hazards Models; D011994:Recombinant Proteins; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron