"effect of high versus low doses of human recombinant erythropoietin on the anemia of prematurity"

recombinant human erythropoietin (rh-epo) is known to accelerate erythropoiesis in preterm infants. the purpose of this study was to compare the effectiveness of early treatment with two doses of rh-epo (high vs. low dose) in the management of anemia of prematurity. twenty preterm infants with hematocrit (hct) < 30% when infant’s age was between 2 to 3 weeks after birth or hct <25% when infant’s age was more than 3 weeks after birth, were divided randomly in two groups, each group including 10 babies. infants in high dose group received 500 u/kg rh-epo twice per week and the low dose group received 500 u/kg rh-epo weekly. all infants were fed human milk supplemented with enteral iron. hematocrit and reticulocyte counts were determined for each infant at the start of the study, 3 days after start of treatment and one week after the end of treatment. the means of gestational age in high dose and low dose groups were 31.4 ± 2.2 and 31.3±2.0 weeks, respectively. means of birth weight in high dose and low dose groups were 1366 ± 243 and 1438±249 gr, respectively. the two groups were significantly different in reticulocyte count at 3 days after treatment (p = 0.047) and in hematocrit at the end of study (p < 0.0001). we concluded the early treatment of anemia of prematurity with high dose rh-epo with supplemental iron significantly increases hematocrit and reticulocyte in preterm infants and reduce the need for blood transfusion in these high risk neonates.