O efeito da eritropoetina humana recombinante no tratamento da anemia da prematuridade

Abstract

Objective: to assess the efficacy of erythropoietin in the prevention and treatment of anemia of prematurity, correlating the use of this drug with weight gain, length, and head circumference and comparing two administration schemes of he same weekly dose: daily use and twice a week.Methods: the study comprised 42 premature newborns with gestational age up to 33 weeks, birthweight up to 1550 g, and postnatal age between 10 and 35 days. The newborns were randomized into three groups: patients in group 1 received seven daily doses of 100 U/kg erythropoietin per week; patients in group 2 received two 350 U/kg erythropoietin doses per week; and patients in group 3 did not receive the drug. Hematologic measurements, blood transfusion requirements, and growth rates were followed during therapy.Results: cases and controls did not differ with respect to weight, length, head circumference, and total time of hospital stay. At the end of the study, no significant difference was observed in the platelet count measurement means, white blood cell count, and ferritin levels in the three groups. However, the final hematocrit and hemoglobin values of patients who did not receive erythropoietin were significantly lower than those of patients who received the drug. The absolute reticulocyte count mean was significantly higher in patients who received erythropoietin after two weeks of treatment when compared with those patients who did not receive the drug. Patients in group 1 e 2 received fewer excessive transfusions (2 or more) than patients in group 3. The administration of 700 U/kg/week erythropoietin significantly reduced the number of excessive blood transfusions. There is no significant difference in blood transfusion volume between patients who received erythropoietin on a daily basis and those who received the drug twice weekly.Conclusions: the use of erythropoietin did not influence weight gain and growth. The administration of 700 U/kg/week erythropoietin in premature infants with gestational age up to 33 weeks and birthweight up to 1550 g stimulates erythropoiesis and significantly reduces excessive blood transfusion requirements. Erythropoietin showed to be a safe and well tolerated medication, with no short-term side effects in the study population.J Pediatr (Rio J) 2001; 77 (2): 75-83: erythropoietin, anemia of prematurity, transfusion, premature. ResumoObjetivos: a proposta do presente estudo foi avaliar a eficácia da eritropoetina na prevenção e tratamento da anemia da prematuridade, correlacionar o uso desta medicação com o ganho de peso, comprimento e perímetro cefálico dos pacientes. Foi realizada também uma comparação entre o uso de eritropoetina diariamente e o uso duas vezes por semana, na mesma dose semanal.Métodos: ensaio clínico que avaliou 42 recém-nascidos prematuros, com até 33 semanas de idade gestacional, peso de nascimento até 1550g e idade pós-natal entre 10 e 35 dias de vida. Os recém-nascidos foram randomizados em três grupos. Os pacientes do grupo 1 receberam 7 doses diárias, de 100U/kg c...

Comparison between one and three doses a week of recombinant erythropoietin in very low birth weight infants

“…This is a new contribution not found in other studies. Similar to other researchers, [30][31][32] we have noted a gradual reduction of hemoglobin in both groups, although at the end of study the once-weekly group presented a lower level. If the groups were comparable at entry and the volume withdrawn was similar, the fact that Group 2 had less hemoglobin could be ascribed to the treatment schedule, but these findings have not shown the impact on transfusion requirements.…”

“…[10][11][12] We wish to highlight the low volume of blood withdrawn per kg, in comparison with other trials. 3,17,21,23,29,30 This fact together with the strict transfusion criteria, could have contributed to the low transfusion requirement observed.…”

Tempo De Uso De Ferro Nas Anemias Ferroprivas

“…Assim, o Ministério da Saúde tornou obrigatória a fortificação das farinhas de milho e trigo com ferro e ácido fólico, por serem alimentos de fácil acesso a população e não terem alterações de suas características organolépticas no processo de fortificação, além de ser economicamente viável ao país (ROCHA, 2000).…”