Early treatment with erythropoietin beta ameliorates anemia and reduces transfusion requirements in infants with birth weights below 1000 g.
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.
Maier
Rolf F
RF
Obladen
Michael
M
Müller-Hansen
Ingo
I
Kattner
Evelyn
E
Merz
Ulrich
U
Arlettaz
Romaine
R
Groneck
Peter
P
Hammer
Hannes
H
Kössel
Hans
H
Verellen
Gaston
G
Stock
Gerd-Jürgen
GJ
Lacaze-Masmonteil
Thierry
T
Claris
Olivier
O
Wagner
Martin
M
Matis
Jacqueline
J
Gilberg
Frank
F
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
D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron