Document Detail


Effects of early erythropoietin therapy on the transfusion requirements of preterm infants below 1250 grams birth weight: a multicenter, randomized, controlled trial.
MedLine Citation:
PMID:  11581447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Infants of </=1250 g birth weight receive multiple erythrocyte transfusions during their hospitalization. We hypothesized that early erythropoietin (Epo) and iron therapy would 1) decrease the number of transfusions received (infants 401-1000 g birth weight; trial 1) and 2) decrease the percentage of infants who received any transfusions (1001-1250 g birth weight; trial 2). METHODS: A total of 172 infants in trial 1 and 118 infants in trial 2 were randomized to treatment (Epo, 400 U/kg 3 times weekly) or placebo/control. Therapy was initiated by 4 days after birth and continued through the 35th postmenstrual week. All infants received supplemental parenteral and enteral iron. Complete blood and reticulocyte counts were measured weekly, and ferritin concentrations were measured monthly. Transfusions were administered according to protocol. Phlebotomy losses and transfusion data were recorded. RESULTS: Treated and placebo/control infants in trial 1 received a similar number of transfusions (4.3 +/- 3.6 vs 5.2 +/- 4.2, respectively). A similar percentage of treated and control infants in trial 2 received at least 1 transfusion (37% vs 46%). Reticulocyte counts were higher in treated infants during each week of the study in both trials. Hematocrits were higher among treated infants from week 2 on in both trials. Ferritin concentrations were higher in placebo/controls than in treated infants at weeks 4 and 8 in trial 1 and at week 4 in trial 2. No adverse effects of Epo or supplemental iron occurred. CONCLUSION: The combination of early Epo and iron as administered in this study stimulated erythropoiesis in infants who were </=1250 g at birth. However, the lack of impact on transfusion requirements fails to support routine use of early Epo.neonate, intravenous iron, donor exposure.
Authors:
R K Ohls; R A Ehrenkranz; L L Wright; J A Lemons; S B Korones; B J Stoll; A R Stark; S Shankaran; E F Donovan; N C Close; A Das
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  108     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-02     Completed Date:  2002-01-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  934-42     Citation Subset:  AIM; IM    
Affiliation:
Departments of Pediatrics, Albuquerque, New Mexico, 87131, USA. rohls@unm.edu
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MeSH Terms
Descriptor/Qualifier:
Anemia, Neonatal / therapy
Blood Transfusion / statistics & numerical data,  utilization*
Child Development / drug effects,  physiology
Erythropoiesis / drug effects,  physiology
Erythropoietin / pharmacology,  therapeutic use*
Female
Humans
Infant, Low Birth Weight / blood*,  physiology
Infant, Newborn
Infant, Premature / blood*,  physiology
Infant, Premature, Diseases / blood,  drug therapy*
Iron / pharmacology,  therapeutic use
Male
Placebos
Grant Support
ID/Acronym/Agency:
M01 RR 00750/RR/NCRR NIH HHS; M01 RR 00997/RR/NCRR NIH HHS; M01 RR 01032/RR/NCRR NIH HHS; M01 RR 02172/RR/NCRR NIH HHS; M01 RR 06022/RR/NCRR NIH HHS; M01 RR 08084/RR/NCRR NIH HHS; M01 RR02635/RR/NCRR NIH HHS; U01 HD19897/HD/NICHD NIH HHS; U01 HD36790/HD/NICHD NIH HHS; U10 HD21385/HD/NICHD NIH HHS; U10 HD27851/HD/NICHD NIH HHS; U10 HD27853/HD/NICHD NIH HHS; U10 HD27856/HD/NICHD NIH HHS; U10 HD27871/HD/NICHD NIH HHS; U10 HD27881/HD/NICHD NIH HHS; U10 HD34167/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Placebos; 11096-26-7/Erythropoietin; 7439-89-6/Iron
Comments/Corrections
Comment In:
Pediatrics. 2002 Dec;110(6):1253-5; author reply 1253-5   [PMID:  12456927 ]
Pediatrics. 2002 Dec;110(6):1253-5; author reply 1253-5   [PMID:  12462238 ]

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