ERYTHROPOIETIN (EPO), PROTEIN AND IRON SUPPLEMENTATION AND THE PREVENTION OF ANEMIA OF PREMATURITY - EFFECTS ON SERUM IMMUNOREACTIVE EPO, GROWTH AND PROTEIN AND IRON-METABOLISM

The effect of recombinant human (r-Hu) erythropoietin (Epo) (300 IU/kg per week for 4 weeks) was studied in healthy preterm infants (n = 14) fed human milk with additional milk protein and high doses of iron. T he controls (n = 15) were in themselves a study group and were used to follow the natural course of anaemia of prematurity on such nutrition . Serum immunoreactive Epo (SiEpo) increased significantly 24 h after r-HuEpo injections (range 36 to > 128 mU/ml) and remained at these lev els throughout the treatment period, r-HuEpo in such moderate doses ke pt haemoglobin above 11 g/dl. Bodyweight gain, protein and iron parame ters indicated adequacy of dietary protein and iron. In controls, siEp o increased during the first weeks after nutritional supplementation, with a concommitant rise in reticulocyte count. Al age 3 weeks, despit e low siEpo levels, reticulocyte counts indicated active erythropoiesi s. Following further moderate increases in siEpo, the reticulocyte cou nt increased to high levels (7%). The reticulocyte response suggests t hat erythropoiesis in preterm infants is less dependent upon Epo level s than in adults.