IN WHICH NEONATES DOES EARLY RECOMBINANT-HUMAN-ERYTHROPOIETIN TREATMENT PREVENT ANEMIA OF PREMATURITY - RESULTS OF A RANDOMIZED, CONTROLLED-STUDY

To assess whether erythropoietin (EPO) treatment is safe and reduces t he need for transfusion, we randomized 44 preterm infants to an EPO gr oup and a comparable control (CON) group. EPO-150 U/kg was given s.c. twice weekly for 6 wk from the 1st wk of life. Hematologic parameters, transfusion requirements, and growth were followed during therapy and for 6 mo thereafter. To better assess in which neonates EPO treatment was effective, we classified retrospectively the EPO and CON groups i nto uncomplicated neonates (EPO A: n = 9, birth weight = 1247 +/- 126 p, gestational age = 29.8 +/- 1.5 wk; CON A: n = 7, birth weight = 121 7 +/- 145 g, gestational ape = 29.9 +/- 1.5 wk) and neonates requiring artificial ventilation (EPO B: n = 16, birth weight = 1169 +/- 249 g, gestational age = 28.1 +/- 2 wk; CON B: n = 12, birth weight = 1173 /- 215 g, gestational age = 28.3 +/- 2 wk). There were significant dif ferences in reticulocytes between both uncomplicated and ventilated ne onates in the EPO group compared with respective control groups. Howev er, the need for transfusion was significantly less in the uncomplicat ed EPO group (EPO A: 0.44 +/- 0.73 versus CON A: 1.28 +/- 0.75, p < 0. 05) but not in the neonates on ventilation (EPO B: 8.25 +/- 5 versus C ON B: 7.75 +/- 3.7). In conclusion, early EPO administration reduces t he need for transfusion in uncomplicated premature neonates. Although stimulation of erythropoiesis was apparent in both uncomplicated and c omplicated neonates, the end-result of increased need for transfusion in complicated neonates was related to altered indication of transfusi on. These infants probably require further or longer EPO administratio n after weaning from ventilation and improvement of clinical condition .