Effects of recombinant human erythropoietin in infants with the anemia of prematurity: A pilot study

Halpérin, Daniel; Wacker, Pierre; G, Lacourt; Félix, Martine; Babel, J; Aapro, Matti; Wyss, M

doi:10.1016/s0022-3476(05)82671-x

Cited by 179 publications

(84 citation statements)

References 32 publications

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“…Secondly, the erythropoietic response to r-HuEPO of infants cannot be predicted from the responses of adults of the same species. Our data in infant rhesus monkeys are consistent with the observation that human premature infants given r-HuEPO in doses known to be effective in adults had either no increase (26) or a very slight increase (27) in Hb production. Preterm human babies have large plasma volumes compared with adults; dosage schedules designed for adults may produce lower circulating r-HuEPO concentrations, as we found in infant monkeys.…”

Section: Methodssupporting

confidence: 89%

“…Although the pattern of erythropoiesis in healthy infant rhesus monkeys differs from that in anemic premature babies, the results of our study provide new information that augments limited data from recent studies on use of r-HuEPO in anemia of prematurity (26,27). The lack of any adverse effects of r-HuEPO in infant monkeys supports the concept that further placebocontrolled clinical trials of r-HuEPO therapy in anemia of prematurity are warranted.…”

Section: Methodssupporting

confidence: 57%

“…r-HuEPO in an uncontrolled study (27), although they did not occur in a larger, placebo-controlled study (26). Secondly, the erythropoietic response to r-HuEPO of infants cannot be predicted from the responses of adults of the same species.…”

Section: Methodsmentioning

confidence: 94%

“…Preterm human babies have large plasma volumes compared with adults; dosage schedules designed for adults may produce lower circulating r-HuEPO concentrations, as we found in infant monkeys. Furthermore, iron deficiency occurred in some babies treated unsuccessfully with r-HuEPO (27). Higher amounts of iron, perhaps even parenteral iron, may need to be given during r-HuEPO therapy for optimal erythropoiesis in both infant rhesus monkeys and premature babies.…”

Section: Methodsmentioning

confidence: 99%

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Age-Related Differences in Erythropoietic Response to Recombinant Human Erythropoietin: Comparison in Adult and Infant Rhesus Monkeys

et al. 1990

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ABSTRACT. Human recombinant erythropoietin (rHuEPO) was given i.v. to rhesus monkeys to compare its safety, erythropoietic effects, and pharmacokinetics in healthy adult and infant animals. Eighteen adult and 18 infant (9-to 15-d-old) monkeys were divided into three groups each of six animals. One group was given 250 U/ kg twice weekly, another was given 100 U/kg twice weekly, and a control group was given the drug vehicle for 6 wk.All animals were healthy throughout this period, and for 10 wk after that. Administration of r-HuEPO at these dosages did not produce any changes in leukocytes, platelets, urea nitrogen, bilirubin, creatinine, alkaline phosphatase, alanine amino transferase, y-glutamyl transferase, and blood pressure in either age group. At 6 wk, both adult treatment groups had statistically significant increases in Hb concentration. The same dosages that produced these increases in Hb concentration in adults produced no changes in Hb concentration in infant monkeys. Despite active erythropoiesis, as determined by reticulocytosis and increased total body Hb, Hb concentration decreased similarly in the infant treatment and control groups. Pharmacokinetic profiles were obtained at 5 wk of dosing. One h after administration, both doses of r-HuEPO produced significantly lower serum r-HuEPO concentration in the infant monkeys compared with the adults. These differences appeared to be due to a larger volume of distribution of r-HuEPO in the infant monkeys. The tn12 of r-HuEPO in circulation was the same in both age groups. (Pediatr Res 28: 567-571,1990) Abbreviations EPO, erythropoietin r-HuEPO, recombinant human erythropoietin The anemia of prematurity, a common complication of preterm birth, is characterized by a progressive fall in Hb concentration, reticulocytopenia, and bone marrow erythroid hypopla-

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Section: Methodssupporting

confidence: 89%

Section: Methodssupporting

confidence: 57%

Section: Methodsmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

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Age-Related Differences in Erythropoietic Response to Recombinant Human Erythropoietin: Comparison in Adult and Infant Rhesus Monkeys

et al. 1990

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“…1,2 However, the fundamental clinical objective of using rEPO in very low birth weight (VLBW) infants has been to slow down the decline in hemoglobin parameters during the first weeks of life and to reduce the transfusion requirement, which is very high for these infants. [3][4][5][6][7] Since the first pilot trial, published by Halperin et al in 1990, 8 rEPO use has spread and many studies have evaluated it as safe and effective. [9][10][11][12] In terms of efficacy, rEPO stimulates erythropoiesis in VLBW infants and diminishes the number of transfusions per infant as well as the cumulative volume transfused and the exposure to multiple donors.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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Objective: To compare transfusion requirements and erythropoietic response in preterms between schedules of rEPO administration once or three times per week, using the same weekly dose.Study Design: Prospective, randomized trial including infants weighing <1500 g at birth and/or were p32 weeks' gestation: Group 1 (60 infants) received subcutaneous rEPO at 250 units kg À1 per dose, three times weekly for 6 weeks; Group 2 (59 infants), at 750 units kg À1 per dose, once weekly for 6 weeks. Efficacy was evaluated based on the transfusion requirement, hemoglobin changes, reticulocyte counts, serum transferrin receptor (sTfR) and serum ferritin. The frequency of adverse effects was registered in both groups.Result: A total of 13 infants were transfused in each group (relative risk: 0.98; 95% confidence interval: 0.4 to 2.3). Phlebotomy loss and red blood cell transfusion volumes received were similar in both groups. Hemoglobin levels were lower at end of study in Group 2 (10.6±1.5 g dl À1 versus 11.5±1.4 g dl À1 ; P<0.003). At end of study, reticulocyte counts and sTfR values increased and serum ferritin values decreased, without significant differences between the two groups. Incidence of complications was similar in both groups. Conclusion:The once-weekly rEPO schedule for very low birth weight infants proved as effective as the three-times-weekly schedule, in relation to erythropoietic stimulus and transfusion requirement.

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Erythropoietin. Biology and clinical applications

Tabbara¹

1993

Archives of Internal Medicine

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Effects of recombinant human erythropoietin in infants with the anemia of prematurity: A pilot study

Cited by 179 publications

References 32 publications

Age-Related Differences in Erythropoietic Response to Recombinant Human Erythropoietin: Comparison in Adult and Infant Rhesus Monkeys

Age-Related Differences in Erythropoietic Response to Recombinant Human Erythropoietin: Comparison in Adult and Infant Rhesus Monkeys

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

Erythropoietin. Biology and clinical applications

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