A randomized, masked study of weekly erythropoietin dosing in preterm infants

J Pediatr. 2012 May;160(5):790-5.e1. doi: 10.1016/j.jpeds.2011.10.026. Epub 2011 Dec 3.

Abstract

Objective: To compare reticulocyte responses of once-per-week erythropoietin (EPO) dosing with 3-times-a-week dosing in preterm infants.

Study design: Infants weighing ≤ 1500 g and ≥ 7 days of age were randomized to once-per-week EPO, 1200 U/kg/dose, or 3-times-a-week EPO, 400 U/kg/dose, subcutaneously for 4 weeks, along with iron and vitamin supplementation. Complete blood counts, absolute reticulocyte counts (ARCs), transfusions, phlebotomy losses, and adverse events were recorded.

Results: Twenty preterm infants (962 ± 55 g, 27.9 ± 0.4 weeks, 17 ± 3 days of age) were enrolled. Groups were similar at baseline. Infants in both groups had increased ARCs, which were similar between treatment groups at the start and end of 4 weeks. Hematocrit remained stable, and similar numbers of transfusions were administered. No adverse effects of either dosing schedule were noted.

Conclusions: Preterm infants respond to weekly EPO by increasing ARCs and maintaining hematocrit. We speculate that once-per-week EPO dosing might be beneficial to preterm infants requiring increased erythropoiesis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Anemia, Neonatal / diagnosis
  • Anemia, Neonatal / drug therapy*
  • Blood Cell Count
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Erythrocyte Count
  • Erythropoiesis / drug effects*
  • Erythropoietin / administration & dosage*
  • Female
  • Follow-Up Studies
  • Hematocrit
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Premature, Diseases / diagnosis
  • Infant, Premature, Diseases / drug therapy
  • Infant, Very Low Birth Weight / blood*
  • Injections, Subcutaneous
  • Intensive Care Units, Neonatal
  • Iron Compounds / administration & dosage
  • Male
  • Pilot Projects
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome
  • Vitamins / administration & dosage

Substances

  • Iron Compounds
  • Vitamins
  • Erythropoietin