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Randomized Controlled Trial
. 2012 May;160(5):790-5.e1.
doi: 10.1016/j.jpeds.2011.10.026. Epub 2011 Dec 3.

A randomized, masked study of weekly erythropoietin dosing in preterm infants

Robin K Ohls  1 , Mashid Roohi, Hannah M Peceny, Ronald Schrader, Ryann Bierer
Affiliations
Randomized Controlled Trial

A randomized, masked study of weekly erythropoietin dosing in preterm infants

Robin K Ohls et al. J Pediatr. 2012 May.

Abstract

Objective: To compare reticulocyte responses of once-per-week erythropoietin (EPO) dosing with 3-times-a-week dosing in preterm infants.

Study design: Infants weighing ≤ 1500 g and ≥ 7 days of age were randomized to once-per-week EPO, 1200 U/kg/dose, or 3-times-a-week EPO, 400 U/kg/dose, subcutaneously for 4 weeks, along with iron and vitamin supplementation. Complete blood counts, absolute reticulocyte counts (ARCs), transfusions, phlebotomy losses, and adverse events were recorded.

Results: Twenty preterm infants (962 ± 55 g, 27.9 ± 0.4 weeks, 17 ± 3 days of age) were enrolled. Groups were similar at baseline. Infants in both groups had increased ARCs, which were similar between treatment groups at the start and end of 4 weeks. Hematocrit remained stable, and similar numbers of transfusions were administered. No adverse effects of either dosing schedule were noted.

Conclusions: Preterm infants respond to weekly EPO by increasing ARCs and maintaining hematocrit. We speculate that once-per-week EPO dosing might be beneficial to preterm infants requiring increased erythropoiesis.

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Figures

Figure 1
Figure 1
Absolute reticulocyte counts in infants receiving once weekly Epo, 1,200 units/kg/dose (left panel) or thrice weekly Epo, 400 units/kg/dose. There were no significant differences between groups in ARC at the beginning or end of the study. ARC increased with both dosing schedules, achieving significance in the three times weekly dosing (p<0.01).
Figure 2
Figure 2
Hematocrit in infants receiving once weekly dosing (left panel) and thrice weekly dosing (right panel). Hematocrit remained stable in both treatment groups, and no significant differences were noted in hematocrit between groups during the four week study.
Figure 3
Figure 3
Circulating erythrocyte volume (CEV in infants receiving once weekly dosing (left panel) and thrice weekly dosing (right panel). CEV is expressed as percent of baseline. CEV increased significantly in both treatment groups to a similar extent (p<0.001, baseline versus week 4 for both groups).
See this image and copyright information in PMC

References

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