FOLLOW-UP OF VERY-LOW-BIRTH-WEIGHT INFANTS AFTER ERYTHROPOIETIN TREATMENT TO PREVENT ANEMIA OF PREMATURITY

Objective: Treatment with recombinant human erythropoietin (rHuEPO) st imulates erythropoiesis and reduces the need for transfusions in hospi talized preterm infants; The aim of our study was to follow very low b irth weight infants after the initial 6 weeks of rHuEPO treatment. Des ign and methods: We randomly assigned 97 very low birth weight infants with a gestational age of 31 weeks or less and birth weight of 1500 g m or less to receive rHuEPO, 300 units/kg per week (erythropoietin (EP O) 300, n = 33), rHuEPO, 750 units/kg per week (EPO 750; n = 28), or n o treatment (control, n = 36). The rHuEPO was administered from the fi rst week of life for 6 weeks. After EPO therapy was discontinued, 75 n eonates were followed weekly until discharge and at 3, 6, and 12 month s of age. Results: Mean numbers (+/-SD) of packed erythrocyte transfus ions per patient from the time rHuEPO therapy was discontinued until d ischarge were 0.38 +/- 0.64 (EPO 300), 0.23 +/- 0.52 (EPO 750), 0.9 +/ - 1.1 (control) (p <0.05 in both EPO groups vs control). Mean reticulo cyte counts at the sixth week were 6% +/- 2.2% (EPO 300), 6.9% +/- 2.2 % (EPO 750), and 3.1% +/- 2.6% (control) in the three groups (p <0.01 in both EPO groups vs control), and at the eighth week were 4.7% +/- 2 .8% (EPO 300), 5.4% +/- 2.7% (EPO 750), and 2.6% +/- 2.2% (control) (p <0.01 in both EPO groups vs control). Serum ferritin levels were sign ificantly higher at the sixth week, and the percentage of hemoglobin F was significantly lower at 6, 8, and 10 weeks in the control group ve rsus EPO groups. At 3, 6, and 12 months of age, there were no differen ces in reticulocytes, ferritin, HbF, and growth among groups. Conclusi on: Preterm infants who received rHuEPO had a normal pattern of erythr opoiesis after the drug was discontinued. These data provide strong ev idence that the anemia of prematurity is the result of a transient dev elopmental abnormality in EPO production.