Erythropoietin treatment of anemia of prematurity

Abstract

Anemia is a frequent finding in preterm infants between 4 and 12 weeks of extrauterine life. The fall in hemoglobin concentration in these infants is often so great that some infants become symptomatic and require blood transfusion. This condition, termed the anemia of prematurity, is characterized by anemia, reticulocytopenia, and bone marrow hypoplasia. Erythropoietin (EPO) levels are very low. The most premature infants experience the lowest levels of EPO and hemoglobin concentration. The delayed switch from hepatic to renal EPO production could play an important role in pathogenesis of this condition owing to the decreased responsiveness of immature hepatic oxygen sensors to hypoxia. In vitro studies have shown that erythroid progenitors from preterm infants existed in adequate numbers and were as response to recombinant human erythropoietin (RHU-EPO) as these of adults. Preliminary data from the clinical trials of RHU-EPO in treatment of anemia of prematurity are associated with an increased hematocrit and reticulocyte count and the need for fewer transfusions.