Iron supplementation enhances response to high doses of recombinant human erythropoietin in preterm infants
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).
METHODSSixty 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.
RESULTSInfants in the
EPO+iron group needed fewer transfusions than controlsmean (95% CI)
1.0 (0.28-1.18) vs 2.9 (1.84-3.88) and received lower volumes of bloodmean (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 controlsmean (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 group65
(55) µg/l than in the EPO+iron group 780 (182) µg/l, and 561 (228)
µg/l in the control infants.
CONCLUSIONSEarly
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.
© 1998 by Archives of Disease in Childhood
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This article has been cited by other articles:
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Ridley, F C, Harris, J, Gottstein, R, Emmerson, A J B
(2006). Is supplementary iron useful when preterm infants are treated with erythropoietin?. Arch. Dis. Child.
91: 1036-1038
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Widness, J. A., Serfass, R. E., Haiden, N., Nelson, S. E., Lombard, K. A., Pollak, A.
(2006). Erythrocyte Iron Incorporation but Not Absorption Is Increased by Intravenous Iron Administration in Erythropoietin-Treated Premature Infants. J. Nutr.
136: 1868-1873
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