The role of recombinant Human erythropoietin in neonatal anemia

Abstract

Aim: To estimate the blood level of Erythropoietin(EPO) in neonates with anemia of prematurity (APO) and in late hypo-regenerative anemia and to clarify role of EPO in correction of anemia and reducing the number of blood transfusions. Methods: This study was carried out on 60 neonates divided into; group I (30 preterm neonates) with AOP received EPO (250 IU/kg/dose subcutaneously 3 times weekly for 4 weeks), compared to group II (30 neonates) with AOP treated only with blood transfusion. CBC parameters and transfusion requirements were followed during therapy. Serum level of EPO was measured by ELISA technique. Results: By the end of the 4th week of therapy, there was significant increase in group I post r-Hu EPO compared to group II regarding reticulocyte counts (P < 0.001) leading to rise of the Hb (P < 0.001), Hct levels (P < 0.001) with subsequent reduction in the overall number of blood transfusions (P < 0.001). Conclusion: EPO therapy in conjunction with iron, vitamin E and folic acid, stimulated erythropoiesis and significantly reduced the need for blood transfusion in AOP.

The Efficacy of Erythrocyte Transfusion in Very Low Birth Weight Infants with Premature Anemia

“…Anemia of prematurity can cause tachycardia, inadequate weight gain, increase oxygen need and apnea or bradycardia (13,27,29). n premature infants, anemia becomes symptomatic when imbalance develops between it's distribution and consumption.…”

Papel de los estimulantes de eritropoyesis en la anemia neonatal

“…Además de estimular la eritropoyesis, inhibe la apoptosis en células vasculares y neuronas y regula la angiogénesis; su expresión depende de la presión arterial de oxígeno y está regulada por la hipoxia (40,41). El uso de eritropoyetina humana recombinante (rHu-EPO) como parte del tratamiento de la anemia del prematuro ha sido ampliamente discutido y controvertido, ya que la administración precoz de esta no reduce el número de transfusiones recibidas (5,41,42); sin embargo, hay estudios que demuestran una disminución en la necesidad de transfusiones sanguíneas (13,43,44).…”

Efficacy of erythropoietin for the late treatment of anemia of prematurity in a level IV neonatal intensive care unit: A retrospective single-center cohort study

“…Multiple studies have reported on the use of rEPO in extremely low gestational age neonates (ELGANs) to stimulate erythropoiesis and decrease the need for red blood cell transfusions. 4,[7][8][9][10][11][12][13][14] Previous trials have demonstrated that the administration of erythropoietin may reduce the need for future red blood cell transfusions, thereby reducing the risk of development of complications related to transfusion administration. 7,8 There is prospective data to both support and discourage the use of erythropoietin in preterm infants.…”