[Recombinant erythropoietin as treatment for hyporegenerative anemia following hemolytic disease of the newborn].
BACKGROUND
The aim of the study is to report results of erythropoietin treatment for late hyporegenerative anemia in the hemolytic disease of the newborn (HDN). Reports previously published concern only a few cases, with controversial results.


METHODS
Case series report concerning 50 neonates with HDN due to Rh, ABO or KpA antigens, aged more than 7 days. Erythropoietin treatment started when hematocrit dropped to levels requiring transfusion, with an inappropriate reticulocyte response (Reticulocyte Production Index <1).


RESULTS
At start of treatment mean age was 24.3 +/- 12.0 days (range 8-65 days), hematocrit 24.1 +/- 2.8% (range 18-30%), and Reticulocyte Production Index 0.34 +/- 0.25 (range 0.05-0.98). Hematocrit and Reticulocyte Production Index showed significant increases after 7 and 14 days of treatment (p <0.001). No difference was observed either between infants with Rh-HDN and ABO-HDN or between Rh-HDN patients with or without intrauterine transfusions. Seven infants (14%) required one packed RBC transfusion during erythropoietin therapy, 2 of them within 72 hours from starting treatment. The percentage of transfused infants showed no difference either between ABO-HDN and Rh-HDN or between Rh-HDN with and without intrauterine transfusions. Moderate, short-lasting neutropenia, not associated to infections, was observed in 11 patients. No other adverse effect was observed.


CONCLUSIONS
The administration of erythropoietin appears to be a safe and useful therapy. Its efficacy should be confirmed by randomized studies.
Donato
Hugo
H
Sanatorio de la Trinidad, Buenos Aires. hugodonato@aol.com
Bacciedoni
Viviana
V
García
Cecilia
C
Schvartzman
Gabriel
G
Vain
Néstor
N
D000741:Anemia, Aplastic / Q000188:drug therapy* / Q000209:etiology*; D004899:Erythroblastosis, Fetal; D004921:Erythropoietin / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D004921:Erythropoietin