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Department of
Paediatrics University of Padova
Via Giustiniani 3 35128 Padova Italy
Correspondence to: Dr Virgilio P Carnielli. Email: carnielli{at}child.pedi.unipd.it
Accepted 18 January
1998
AIMS
To determine
whether iron supplementation would enhance erythropoiesis in preterm
infants treated with high doses of human recombinant erythropoietin
(r-HuEPO).
METHODS
Sixty three
preterm infants were randomly allocated at birth to one of three groups
to receive: r-HuEPO alone, 1200 IU/kg/week (EPO); or r-HuEPO and
iron, 1200 IU/kg/week of r-HuEPO plus 20 mg/kg/week of intravenous iron
(EPO+iron); or to serve as controls. All three groups received blood
transfusions according to uniform guidelines.
RESULTS
Infants in the
EPO+iron group needed fewer transfusions than controls
mean (95% CI)
1.0 (0.28-1.18) vs 2.9 (1.84-3.88) and received lower volumes of blood
mean (95% CI) 16.7 (4.9-28.6) vs 44.4 (29.0-59.7) ml/kg. The EPO group
also needed lower volumes of blood than the controls
mean (95% CI)
20.1 (6.2-34.2) vs 44.4 (29.0-59.7) ml/kg,
but the same number of transfusions, 1.3 (0.54-2.06) vs 2.9 (1.84-3.88). Reticulocyte and
haematocrit values from postnatal weeks 5 to 8 were higher in the
EPO+iron than in the EPO group, and both groups had higher values than
the controls. Mean (SEM) plasma ferritin was lower in the EPO group
65
(55) µg/l than in the EPO+iron group 780 (182) µg/l, and 561 (228)
µg/l in the control infants.
CONCLUSIONS
Early
administration of high doses of r-HuEPO with iron supplements
significantly reduced the need for blood transfusion. Intravenous iron
(20 mg/kg/week in conjunction with r-HuEPO yielded a higher
reticulocyte count and haematocrit concentration after the forth week
of life than r-HuEPO alone. Infants treated with r-HuEPO alone showed
signs of reduced iron stores.
This article has been cited by other articles:
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F C Ridley, J Harris, R Gottstein, and A J B Emmerson Is supplementary iron useful when preterm infants are treated with erythropoietin? Arch. Dis. Child., December 1, 2006; 91(12): 1036 - 1038. [Full Text] [PDF] |
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J. A. Widness, R. E. Serfass, N. Haiden, S. E. Nelson, K. A. Lombard, and A. Pollak Erythrocyte Iron Incorporation but Not Absorption Is Increased by Intravenous Iron Administration in Erythropoietin-Treated Premature Infants J. Nutr., July 1, 2006; 136(7): 1868 - 1873. [Abstract] [Full Text] [PDF] |
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