ABSTRACT
Seventy premature infants (birthweight 1.75 kg or less, gestational age 33 weeks or
less) with hemoglobin less than 10 g/dL and hematocrit less than 30% were studied
and randomly divided into three groups. All of them received oral elemental iron 3
mg/kg/day and vitamin E 5 mg/kg/day during the study period. Recombinant human erythropoietin
(rHuEPO) 150 U/kg was administered intravenously twice a week for 4 weeks in group
A (26 infants). Infants in group A received a total of 4 erythrocyte transfusions
because of frequent apnea. Infants in group B (25 infants) received erythrocyte transfusion
when their hemoglobin levels was less than 10 g/dL with signs and symptoms (including
tachycardia, tachypnea, poor feeding, apnea, poor weight gain) attributed to anemia
or who had a hemoglobin less than 8 g/dL even if asymptomatic. Infants in group B
received a total of 36 erythrocyte transfusions. Infants in group C (19 infants) were
assigned to a non-rHuEPO and nontransfusion group. Three of the 19 premature infants
in group C received erythrocyte transfusions later because of frequent and prolonged
apneic episodes and were excluded from this study. Our data revealed that reticulocyte
and serum erythropoietin values were higher (p < 0.01) in rHuEPO-treated group than transfusion group and hemoglobin and hematocrit
values were lower in group C than the other two groups during the rHuEPO treatment
period. No significant difference (p > 0.05) was found in neutrophil and platelet counts among these three groups. Serum
ferritin values were found lower in the rHuEPO-treated group than the other two groups.
Lower weight gain was found in infants in group C. We conclude that rHuEPO administration
can reduce the need for blood transfusion. Poor weight gain can be found in infants
with anemia of prematurity who do not receive rHuEPO or blood transfusion therapy.
Keywords
Anemia of prematurity - recombinant human erythropoietin
