RECOMBINANT-HUMAN-ERYTHROPOIETIN IN THE A NEMIA OF PREMATURITY

During the last 5 years, about 400 preterm infants were treated with r ecombinant human erythropoietin (rhEPO) in controlled trials to reduce the need for red cell transfusions. The effective dose in preterm inf ants was 300-1200 IU/kg/week, which was markedly higher than in adults . Adverse effects or impairment of neutrophil and platelet counts due to rhEPO therapy were not observed. Most infants developed dose depend ent reticulocytosis and iron deficiency indicating stimulated erythrop oiesis. Statistical metaanalysis proved the number of transfused infan ts to be reduced by 18%. The smallest effect was obtained in very sick infants with birth weights < 1200 g, during the first two weeks of li fe in whom haemorrhagic anaemia due to diagnostic blood loss prevails. To manage the anaemia of prematurity, rhEPO is one tactic in a therap eutic strategy which also should include attempts to increase the red cell mass by placental transfusion at birth, to minimize diagnostic bl ood sampling, and to optimize iron supplementation and nutrition.