ERYTHROPOIETIN, PROTEIN, AND IRON SUPPLEMENTATION AND THE PREVENTION OF ANEMIA OF PREMATURITY

The effectiveness of recombinant human erythropoietin (r-HuEpo) in rai sing haemoglobin concentrations in very low birthweight infants was ex amined in a randomised multicentre study. Twenty nine 'healthy; approp riate for gestational age infants with birth weights 900-1400 g entere d the study at 3 weeks of age. All infants received breast milk supple mented with 9 g/l human breast milk protein from 3 to 8 weeks of age. Eighteen mg iron was given daily from week 3 and was doubled if serum iron concentration fell below 16.0 mumol/l. Fourteen infants were rand omised to receive 100 U/kg r-HuEpo subcutaneously three times a week f rom week 3 to week 7; 15 infants served as controls. After one week re ticulocyte and haemoglobin concentrations were significantly higher in the r-HuEpo treated group and the haemoglobin values remained signifi cantly higher throughout r-HuEpo treatment and at the concentrations o bserved in full term infants. No adverse effects were associated with the treatment. In stable very low birthweight infants with optimal iro n and protein intakes, moderate dose r-HuEpo can produce significant g ains in red cell production that may be clinically useful.