EFFECTS OF RECOMBINANT-HUMAN-ERYTHROPOIETIN ON FETAL AND ADULT HEMOGLOBIN IN PRETERM INFANTS

In the present study we assess the effect of recombinant human erythro poietin (r-HuEpo) upon levels of fetal Kb (HbF) and adult Hb (HbA) in preterm infants. Twenty-eight ''healthy,'' appropriate for gestational age infants with birth weights 900-1400 g entered the study at 3 wk o f age. Fourteen infants were randomized to receive r-HuEpo, and 14 inf ants served as controls. Four controls and six r-HuEpo treated infants had been transfused before study start, whereas four control infants were transfused in the course of the study. The untransfused infants s howed a high HbF/Hb ratio during the study with only a weak tendency t o decline toward the expected time of delivery. The total Hb mass incr eased (p < 0.05) more in the r-HuEpo-treated infants than in the untre ated, whereas the rise in HbF mass was similar in the two groups. Afte r each transfusion, the HbF/Hb ratio reverted gradually to the ratio e xpected at the infant's postconceptional age. There was no difference in the production rate of HbF between r-HuEpo-treated infants and cont rols. The present data indicate that the HbF/HbA ratio in preterm infa nts is subject to the same programmed mechanisms which govern intraute rine erythropoiesis until term and that exogenous r-HuEpo does not inf luence this pattern significantly.