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Early treatment with erythropoietin beta ameliorates anemia and reduces transfusion requirements in infants with birth weights below 1000 g.

Authors:
Rolf F Maier Michael Obladen Ingo Müller-Hansen Evelyn Kattner Ulrich Merz Romaine Arlettaz Peter Groneck Hannes Hammer Hans Kössel Gaston Verellen Gerd-Jürgen Stock Thierry Lacaze-Masmonteil Olivier Claris Martin Wagner Jacqueline Matis Frank Gilberg

J Pediatr 2002 Jul;141(1):8-15

Objective: To investigate whether recombinant erythropoietin (rhEPO) reduces the need for transfusion in extremely low birth weight (ELBW) infants (birth weight 500-999 g) and to determine the optimal time for treatment.

Methods: In a blinded multicenter trial, 219 ELBW infants were randomized on day 3 to one of 3 groups: early rhEPO group (rhEPO from the first week for 9 weeks, n = 74), late rhEPO group (rhEPO from the fourth week for 6 weeks, n = 74), or control group (no rhEPO, n = 71). All infants received enteral iron (3-9 mg/kg/day) from the first week. The rhEPO beta dose was 750 IU/kg/week. Success was defined as no transfusion and hematocrit levels never below 30%.

Results: Success rate was 13% in the early rhEPO group, 11% in the late rhEPO group, and 4% in the control group (P =.026 for early rhEPO versus control group). Median transfusion volume was 0.4 versus 0.5 versus 0.7 mL/kg/day (P =.02) and median donor exposure was 1.0 versus 1.0 versus 2.0 (P =.05) in the early rhEPO group, the late rhEPO group, and the control group, respectively. Infection risk was not increased and weight gain was not delayed with rhEPO beta.

Conclusion: Early rhEPO beta treatment effectively reduces the need for transfusion in ELBW infants.

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http://dx.doi.org/10.1067/mpd.2002.124309DOI Listing
July 2002

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