Oral iron is sufficient for erythropoietin treatment of very low birth-weight infants

The aim of this study was to compare two different doses and means of admin istration of iron in recombinant human erythropoietin (rHuEPO)-treated very low birth-weight (VLBW) infants. VLBW infants (n = 41) were randomized to one of three groups. Fourteen infants were treated with rHuEPO (300 IU/kg t hree times a week s.c.) and oral iron (ferrofumarate, 6 mg of iron/kg per d ay). Another 14 infants received the same erythropoietin dose and intramusc ular iron (ferroxypolymaltose, once 12 mg of iron/kg weekly). Thirteen infa nts were treated with the same dose of intramuscular iron but did not recei ve rHuEPO. After the 3-week study period, haemoglobin concentrations and re ticulocyte counts were similar in the rHuEPO-treated groups and both were h igher than in the group not receiving rHuEPO (P < 0.001). In both rHuEPO-tr eated groups the transferrin receptor concentration increased from 6.8-7.2 mg/l to 10.5-11.3 mg/l. Conclusion In erythropoietin-treated very low birth weight infants the iron need for erythropoiesis can be met by oral administration of iron.