Effect of Short-Term Erythropoietin Therapy in Anemic Premature Infants

Abstract

OBJECTIVE:To determine the effectiveness of a 10-day subcutaneous erythropoietin (rHuEpo) course of 300 units per kg per dose plus oral iron compared to oral iron alone in anemic infants during their convalescent phase of illness. STUDY DESIGN:Prospective, randomized trial performed at a 40-bed, teaching, referral, level III, neonatal intensive care unit. Infants with a gestational age at birth of less than 32 weeks, hematocrit of less than or equal to 28% with a corrected reticulocyte count of less than or equal to 5%, postconceptual age of less than 48 weeks or 5 months chronological age, and a diagnosis of anemia of prematurity were considered for inclusion. Major outcome parameters included hematocrit, corrected reticulocyte count and red cell transfusion requirements. RESULTS:A total of 60 infants were enrolled (n ¼ 30 per group). Infants randomized to rHuEpo had a significantly higher post-treatment hematocrit and corrected reticulocyte count than infants in the iron only group (p<0.001). There was a trend towards fewer red cell requirements in the rHuEpo group. CONCLUSIONS:The rHuEpo regimen studied here was associated with an acute improvement in hematocrit and corrected reticulocyte counts. This study did not demonstrate a statistically significant decrease in transfusion therapy, in part related to increased subsequent use of rHuEpo in the control group. Taken together, these data demonstrate that this regimen can effectively treat anemia in convalescent premature infants.

Erythropoietin pharmacokinetic/pharmacodynamic analysis suggests higher doses in treating neonatal anemia

“…In the wake of experimental evidence documenting expanded plasma volume and higher EPO clearance in neonates compared to adults, doses higher than those proven effective in treating adult anemia have been administered. Subsequent trials using higher r‐HuEPO doses were able to stimulate significant erythropoiesis and also demonstrate modest yet significant reductions in RBC transfusions 11,24–28,55,56 . Despite these encouraging results, there are still conflicting reports on the utility of r‐HuEPO in that the efficacy in increasing reticulocyte counts and stimulating bone marrow activity could not be translated to reduced transfusion requirements 29,32,33 .…”

Prevención de anemia en prematuros: transfusiones con eritropoyetina. Hospital de San José, 2006-2008

“…En este grupo la anemia es a menudo el resultado combinado de pérdida iatrogénica de sangre, pobres reservas de hierro e inhabilidad para la reproducción de glóbulos rojos a la par con el crecimiento somático. 1 Aunque algunos de los riesgos de enfermedades a través de las TR sanguíneas se han reducido en los países desarrollados, también es cierto que existe un aumento en el número de agentes infecciosos potencialmente transmisibles por esta vía, siendo una de las complicaciones más temidas. 2 Según el informe de la FDA entre los años 1986 y 1991 el 16% de las TR fatales habrían estado contaminadas con agentes infecciosos como Pseudomonas, Yersinia y Staphylococcus epidermidis.…”

Η Δράση Των Αντιοξειδωτικών Μορίων U – 74389 G Και Της Ερυθροποιητίνης, Σε Πειραματικό Πρότυπο Ισχαιμίας / Επαναιμάτωσης Θήλεων Γεννητικών Οργάνων Αρουραίου

“…ακολουθούμενους από 80 ως 120 s/c (rHuEpo) units/kg σωματικού βάρους με τιτλοποίηση δόσεως σύμφωνα με το επίπεδο Hb. Οι Reiter PD et al βελτίωσαν 88 τον hct και διόρθωσαν τον δικτυοερυθροκυτταρικό δείκτη (p<0.001) σε πρόωρα < 32 weeks βρέφη με hct < 28% με σχήμα rHuEpo. Ο Shander A συμπέρανε 89 ότι εξωγενής ΕΡΟ είχε σαν αποτέλεσμα υψηλότερο hct ICU σε ασθενείς υφιστάμενους ριζική προστατεκτομή.…”