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Prophylactic Treatment of Anemia of Prematurity with Recombinant Human Erythropoietin and High Doses of Iron

Journal of the Korean Pediatric Society 1997;40(3):361-367.
Published online March 15, 1997.
Prophylactic Treatment of Anemia of Prematurity with Recombinant Human Erythropoietin and High Doses of Iron
Young Ho Lee2, Ahn Hong Choi2, Soon Yong Lee1, Jeong Sook Park2, Bong Keun Choi2, Hyoung Shim Chang2
1Department of Pediatrics, Inje University Pusan Paik Hospital, Pusan, Korea
2Department of Pediatrics, Dong-A University School of Medicine Pusan, Korea
미숙아 빈혈에서 Recombinant Erythropoietin과 고용량 철분제제의 예방적 치료효과
이영호2, 최안홍2, 이순용1, 박정숙2, 최봉근2, 장형심2
1인제대학교 부산백병원 소아과학교실
2동아대학교 의과대학 소아과학교실
Abstract
Purpose
: We conducted randomized study to determine whether high doses(6mg/kg/ day) of iron would exert a more supplemental effect than low doses(3mg/kg/day), and which regimen of recombinant human erythropoietin(rHuEPO) and iron would be more beneficial in the prophylactic treatment of anemia of prematurity.
Methods
: We randomly assigned 38 sick premature infants who were more likely than symptom-free premature infants requiring erythrocyte transfusions for infants with anemia of prematurity to receive rHuEPO,100unit/kg, tiw, subcutaneously, plus iron, 3mg/kg/day,po,daily from the second day oflife(group 1),100unit/kg and 6mg/kg/ day(group 2),200unit/kg and 3mg/kg/day(group 3),and 200unit/kg and 6mg/kg/day (group4), respectively.
Results
: There were no significant differences of hemoglobin levels and iron balances during treatment among all 4 groups. The rates of increase in reticulocyte counts were greater in group 4 and group 2 compared with group 3 and group 1, respectively, though these rates were statistically not significant. The blood volume differences(volume of phlebotomies-volume of transfusions) during treatment were higher in group 4 compared with group 1(p<0.05).
Conclusion
: High doses of iron may be more effective in rapidly increasing reticulocyte counts, and 200unit/kg, tiw of rHuEPO plus 6mg/kg/day of iron is more beneficial in reducing the need for blood transfusions than any other regimen. Therefore the prophylactic treatment of anemia of prematurity and acute blood loss from frequent blood sampling in risky premature infants with rHuEPO, 200unit/kg, tiw, subcutaneously, plus iron 6mg/kg/day, po, daily from the second day of life is effective in reducing the number of blood transfusions. Additional controlled trials utilizing high doses of iron with rHuEPO andlarger numbers of patients are justified.
Key Words: Recombinant Human Erythropoietin, Anemia of Prematurity, Prophylactic Treatment


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