RECOMBINANT ERYTHROPOIETIN ANDBLOOD TRANSFUSION IN VERYLOW BIRTH WEIGHT INFANTS

Background: Very low birth weight infants (<1500 g) frequently require blood transfusions because of repeated blood sampling accompanied byanemiaofprematurity. Methods: In an attempt to identify the effect of human recombinant erythropoietin to decrease the requirement for blood transfusions, erythropoietin was administered to 24 preterm infants less than 1500 g prospectively from September 1999 tillDecem ber 2000. Data about the characteristics of the population, the severity of diseases, and treatment with erythropoietin, clinical diagnosis, initialand subsequent hemoglobin, volume of blood loss, and the number of blood transfusions were recorded. These results were compared with data from the recorded information of 49 infants who did not receive erythropoietin during those past 2 years. There were no differences between the 2 groups with regard to the gestational age, birth weight, clinical diagnosis, severity of the illness, primary causes of admission, and initial hematologic parameters such as hemoglobin, hematocrit and reticulocytes. Erythropoietin was administered in a dose of 200 IU/kg three times weekly for 6-8 weeks accompanied with iron supplement 6 mg/ kg/day. Transfusions were administered according to protocol. Results: There was no significant difference between the number of blood transfusion among these 2 groups (p= 0.07). However, transfusions in the erythropoietin treated group were fewer in comparison to the other group (1.9 +/-1.6 to 3.2 +/-1.1). No difference was observed between final hemoglobin and hematocrit levels among the two groups (10.3 +/- 0.9 vs. 10.4 +/- 0.7 and 33.7 +/- 2.3 vs. 32.2 +/- 2.2). Conclusion: Verylow birth weight infants receive frequent blood transfusions but a reduction in transfusion requirements was not apparent after administration of erythropoietin and iron in preterrn infants in this study. However, the lack of impact on transfusion requirements fails to support routine use of erythropoietin