Weekly intravenous administration of recombinant human erythropoietin in infants with the anaemia of prematurity

Beck, D; Masserey, Éric; Meyer, Matthias; Calame, Antoanella

doi:10.1007/bf02026707

Cited by 48 publications

(25 citation statements)

References 30 publications

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“…Portanto, um RN pequeno para a idade gestacional (peso desproporcionalmente baixo para a idade gestacional), teoricamente, teria um menor risco de necessitar TS. Observou-se uma estabilidade clínica, cujos critérios foram descritos em material e métodos, de todos pacientes, assim como está nas publicações da maioria dos autores [1][2][3]9,22,[27][28][29] . Apesar de alguns estudos não terem evidenciado correlação do Ht com a manifestação respirató-ria 4 , um dos critérios estabelecidos por Strauss e colaboradores 30 , em 1990, para indicar a TS seria a manutenção do Ht em 40% naqueles pacientes com doenças respiratórias.…”

Section: Discussionunclassified

“…A eficácia da EPO em reduzir as TSs realizadas em PMTs foi demonstrada em vários ensaios clíni-cos [1][2][3]10,17,22,23,[26][27][28][29]32 . Neste estudo, apesar de os dados indicarem que os pacientes sem o tratamento com EPO tendem a necessitar de um maior volume de sangue transfundido, o teste estatístico não evidenciou diferença significativa entre os grupos.…”

Section: Discussionunclassified

“…Durante as primeiras semanas de vida, todos os RNs apresentam declínio dos glóbulos vermelhos, o que representa uma adaptação fisiológica ao ambiente extra-uterino [1][2][3] . Nos prematuros essa diminuição da hemoglobina (Hb) é mais rápida 4,5 , e seu valor mínimo é mais baixo 6 quando comparado ao dos RNs a termo 2 , denominando-se de anemia da prematuridade.…”

Section: Introductionunclassified

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The effect of recombinant human erythropoietin on the treatment of anemia of prematurity

Rocha¹,

Benjamin²,

Procianoy³

2001

J Pediatr (Rio J)

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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...

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Section: Discussionunclassified

Section: Introductionunclassified

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The effect of recombinant human erythropoietin on the treatment of anemia of prematurity

Rocha¹,

Benjamin²,

Procianoy³

2001

J Pediatr (Rio J)

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“…1,300 preterm infants from 28 studies were included in an analysis of late treatment with EPO (between 8 and 28 days of life). (25)(26)(27)(28)(29)(30) The number of transfusions decreased and the volume of administered blood decreased significantly. In spite of statistically significant differences the clinical value is not that great because most preterm infants are administered transfusion prior to treatment with EPO.…”

Section: Erythropoietinmentioning

confidence: 99%

Treatment with erythropoietin in neonatology

Miksić¹,

Tanja²,

Robert³

et al. 2016

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The article presents the basics and control of erythropoiesis in the fetus and the newborn, the development of anaemia of prematurity and its treatment, with an emphasis on the use of human recombinant erythropoietin. The Intensive Care Unit of the Paediatric Clinic Maribor began treating anaemia of prematurity with erythropoietin in 2000. After introducing the treatment, the clinic found that the number of blood product transfusions and the needed blood volume decreased. In addition to erythropoietin, this was the result of stricter criteria for applying transfusion of concentrated erythrocytes.

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“…In vitro studies [3,4] as well as one animal experiment [5], however, suggest that high concentrations of rHuEPO might divert multipotent progenitors into erythroid maturation at the expense of granulocyte production. Neutropenia, presumably due to stem-cell competition [6], has been observed in small numbers of infants given EPO in uncontrolled trials [7][8][9][10]. Controlled randomized clinical studies, however, reported no reduction in absolute neutrophil counts [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Recombinant Human Erythropoietin on Circulating Hematopoietic Progenitor Cells in Anemic Premature Infants

et al. 1997

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In vitro and animal studies suggest that high concentrations of recombinant human erythropoietin (rHuEPO) might divert multipotent progenitors into erythroid maturation at the expense of granulocyte production. We determined whether changes of number and lineage commitment of peripheral blood progenitor cells occur in premature infants during therapy with rHuEPO. Thirty preterm infants were randomly assigned either to receive 300 IU of eopoetin alpha s.c. per kilogram body weight three times a week for four weeks or to a control group. At study entry and after two weeks of treatment the numbers of circulating BFU-E, granulocyte-macrophage colonyforming units (CFU-GM) and granulocyte-erythrocytemacrophage-megakaryocyte CFU (CFU-GEMM) were analyzed by semisolid culture technique, CD34 + cells and early myeloid CD34 + CD45RA -progenitors by flow cytometry. As compared with the control group, rHuEPO treatment did not exert any significant modulatory effect on numbers of CFU-GM, nor was there a significant change in numbers of BFU-E, CFU-GEMM, total-CFU, percentage of CD34 + or CD34 + CD45RA -cells. Mean neutrophil count was not significantly reduced at any period during the study. Compared with the control group, the infants receiving rHuEPO had higher hematocrit values (p = 0.003) and absolute reticulocyte counts (p < 0.001). The median cumulative volume of blood transfused per kilogram per day was 0.86 ml (first quartile 0.5 ml; third quartile 1.1 ml) in the control group and 0 ml (first quartile 0 ml; third quartile 0.47 ml) in the rHuEPO group (p = 0.038). We conclude using a relatively high dose of rHuEPO in premature infants, no significant in vivo effect on circulating peripheral blood progenitor or neutrophil count could be detected. Stem

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Weekly intravenous administration of recombinant human erythropoietin in infants with the anaemia of prematurity

Cited by 48 publications

References 30 publications

The effect of recombinant human erythropoietin on the treatment of anemia of prematurity

The effect of recombinant human erythropoietin on the treatment of anemia of prematurity

Treatment with erythropoietin in neonatology

The Effect of Recombinant Human Erythropoietin on Circulating Hematopoietic Progenitor Cells in Anemic Premature Infants

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