Epoetin alfa in anaemic children or adolescents on regular dialysis

Mg, Bianchetti; I, Hämmerli; Roduit, C.; Neuhaus, Thomas J.; Leumann, Ernst; Oetliker, O

doi:10.1007/bf01958435

Cited by 16 publications

(9 citation statements)

References 13 publications

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“…Serum ferritin levels fell independently of the dose of rHuEPO but somewhat faster than is normally observed in early postnatal life [16]. These changes constitute additional evidence that rHuEPO effectively stimulated the proliferaton of the erythroid cell pool, thereby increasing the incorporation of circulating iron into maturing red cells, as shown in older patients [3,10,28]. Interestingly, the standard dose of oral iron (2-5 mg/kg per day) that is usually sufficient to prevent late iron deficiency anaemia in premature infants proved insufficient in some patients to sustain effective erythropoiesis during rHuEPO therapy.…”

Section: Discussionmentioning

confidence: 85%

“…No or minimal platelet count changes have been observed in adults [10,28] or in children [3] treated with rHuEPO, but thrombocytosis has been described in murine studies [2] during the first days of therapy. An effect of rHuEPO on megakaryocytopoiesis has been postulated [11], but thrombocytosis is commonly associated with iron depletion [23], and could have resulted in our patients from the rapid fall in serum iron concentration that occurred during rHuEPO therapy.…”

Section: Discussionmentioning

confidence: 99%

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Recombinant human erythropoietin in the treatment of infants with anaemia of prematurity

et al. 1992

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Recombinant human erythropoietin (rHuEPO) was administered subcutaneously three times a week to 18 infants with the anaemia of prematurity at doses of 75, 150, 300, or 600 units/kg per week for 4 weeks, starting at 3-4 weeks of postnatal age. A significant and dose-dependent increase in reticulocyte count was observed from a mean baseline value of 71 x 10(9)/l to 200 x 10(9)/l after 3 weeks of therapy, compared with a change from 69 to 97 x 10(9)/l in 66 historical controls. The haematocrit value remained unchanged during rHuEPO treatment, whereas it steadily declined until 9 weeks of postnatal age in the controls. These effects were accompanied by a marked reduction in serum iron concentration and transferrin saturation in patients receiving standard-dose iron supplements, but not in those given larger doses. Only 3 of 18 patients required a red blood cell transfusion. These infants were among the most anaemic at entry into the study and 2 of them were unable to complete rHuEPO therapy, while the third developed iron deficiency anaemia. These data indicate that rHuEPO with appropriate iron supplementation may accelerate the recovery from anaemia of prematurity. Larger scale placebo-controlled studies are now needed to confirm these findings and verify their impact on transfusion requirements of premature infants.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Recombinant human erythropoietin in the treatment of infants with anaemia of prematurity

et al. 1992

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“…[24][25][26] Controlled trials in children support rHuEPO use in both hemodialysis and peritoneal dialysis. Lerner et al demonstrated that rHuEPO use is common: 81% of patients were administered erythropoietin at baseline and 93% of patients after two years of dialysis.…”

Section: Renal Failurementioning

confidence: 99%

The Changing Transfusion Practice of Neonatal and Pediatric Surgery

Kling

2002

Transfus Alt Transfus Med

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The use of erythrocyte transfusions to treat anemia in neonatal and pediatric surgery patients has changed dramatically over the last decade. Recombinant human erythropoietin (rHuEPO) has been shown to decrease transfusion exposure in many disease states in both adults and children. rHuEPO has also been used perioperatively in children. This paper discusses perioperative anemia, the current status of rHuEPO therapy, surgical and non-surgical strategies that minimize blood loss, and transfusion therapy in the pediatric surgical patient. 2 Although few prospective studies have investigated perioperative transfusion criteria, a recent review suggests that a hemoglobin transfusion threshold of 8 g/dL should be used in surgical patients without risk factors for tissue ischemia, and 10 g/dL could be justified in those at risk for ischemia. 3In current surgical practice, very few randomized clinical trials examining transfusion triggers are found. 4 In pediatric surgery patients, even less information about transfusion criteria is known. Severe anemia is seen in prematurity and in several disease processes. rHuEPO has been shown to decrease transfusion exposure in many disease states and has been used in perioperative settings. We will provide an overview of the treatment of the anemias of prematurity, renal failure, and cancer, as children with these problems frequently become surgical patients. Additionally, this review will discuss the prevention and treatment of anemia in children who are surgical patients. Children present with unique problems related to anemia,

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“…Exacerbation of hypertension has been reported by several authors in both non-dialysis CKD and children on dialysis [14][15][16][17][18][19]. However, many of the studies excluded children with moderate or uncontrolled hypertension, either before or during the trial period.…”

mentioning

confidence: 99%

“…Consequently, the use of lower doses of epoetin (approximately 150 U/kg per week) is recommended. In light of studies supporting a prothrombotic potential of epoetin in children, it has been suggested that epoetin administration be deferred for at least 2 weeks after surgery for arteriovenous (AV) fistula to prevent fistula thrombosis [13,14,21].…”

mentioning

confidence: 99%