Recombinant Human Erythropoietin vs Transfusions in the Treatment of Anemia of Prematurity

Effect of recombinant human erythropoietin on transfusion needs in preterm infants

“…Further cost savings may be achieved by splitting a 2000 U r‐HuEPO vial into multiple doses under laminar flow and sharing it among infants receiving EPO in that week or by using a single vial each day for all infants receiving EPO. Studies 23,24 evaluating cost‐effectiveness of EPO versus transfusions to treat the anaemia of prematurity showed definite cost benefit with the practice of vial sharing.…”

“…5,6,14,15 Multiple studies have attempted to reduce the transfusion requirements of preterm infants through the use of exogenous EPO. [7][8][9][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Earlier trials using EPO at less than 300 U/kg per week showed no reduction in the transfusion requirements of VLBW infants. 16,17,24 Nevertheless, data from controlled trials published since 1990 suggest that EPO at doses of over 500 U/kg per week is effective in inducing erythropoiesis and reduces transfusion requirements of VLBW infants.…”

“…[7][8][9][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Earlier trials using EPO at less than 300 U/kg per week showed no reduction in the transfusion requirements of VLBW infants. 16,17,24 Nevertheless, data from controlled trials published since 1990 suggest that EPO at doses of over 500 U/kg per week is effective in inducing erythropoiesis and reduces transfusion requirements of VLBW infants. 8,[17][18][19][20] These studies have been difficult to compare because of differences in study design, entry criteria, timing and dose of drug administration and variation in caloric intake among study infants.…”

“…In vitro studies have confirmed that the erythroid progenitors of preterm infants are responsive to EPO 5,6,14,15 . Multiple studies have attempted to reduce the transfusion requirements of preterm infants through the use of exogenous EPO 7–;9,16–;29 . Earlier trials using EPO at less than 300 U/kg per week showed no reduction in the transfusion requirements of VLBW infants 16,17,24 .…”

Anemia in the Preterm Infant: Erythropoietin Versus Erythrocyte Transfusion—It's not that Simple

“…[30, 32, 71–74] The results varied, and the relative benefit of r-Epo for AoP is related to the study design (early versus late treatment; liberal versus restrictive transfusion criteria), patient population, and value assigned to complex outcomes. Not all studies took into account the risk of infection transmission, exclusion of which would lower the cost of transfusion.…”