Stepping up versus standard doses of erythropoietin in preterm infants: a randomized controlled trial.
In this study, it is hypothesized that a planned increase in the dose of recombinant human erythropoietin (rh-EPO) can prevent transfusion in very low birth weight infants. Two different regimens of rh-EPO were administrated, one consisting in increasing dosage up to 5000 U/kg/wk, according to the individual reticulocytes response, and the second in a standard therapy of 1250 U/kg/wk. Fifty-one infants participated. Despite a significant higher reticulocytosis, the study was prematurely terminated due to the results of an interim analysis showing that transfusion was not avoided by increasing the rh-EPO. No significant differences were found between the two regimens concerning transfusion rate, volume transfused, gain in weight, and adverse effects. Progressive titration of rh-EPO to improve the biological response does not leave premature infants free of transfusion.
Gumy-Pause
Fabienne
F
Department of Pediatrics, Hematology/Oncology Unit, University Hospital of Geneva, HUG 6, rue Willy Donze, CH-1211 Geneva 14, Switzerland. fabienne.gumypause@medecine.unige.ch
Ozsahin
Hulya
H
Mermillod
Bernadette
B
Cingria
Laurence
L
Berner
Michel
M
Wacker
Pierre
P
D001724:Birth Weight; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D007223:Infant; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D017701:Reticulocyte Count; D012156:Reticulocytes / Q000187:drug effects / Q000378:metabolism; D045262:Reticulocytosis / Q000187:drug effects; D012189:Retrospective Studies; D016019:Survival Analysis; D065227:Transfusion Reaction; D016896:Treatment Outcome
D011994:Recombinant Proteins; D004921:Erythropoietin