The current data suggest that inadequate levels of erythropoietin are an important event in the pathophysiology of the anaemia of prematurity. Clinical trials show that the use of recombinant human erythropoietin (rHu-epo) might prevent the anaemia and reduce the need for blood transfusions, although there is still no consensus about dose and schedule for administration. The objectives of this study are: (1) to asses the efficacy of rHu-epo in decrease transfusions for the of prematurity and (2) to compare two therapeutic schedules: daily use versus twice a week.
We conducted a prospective controlled randomised study in a single institution. We assigned all premature infants with gestational age ≤ 33 weeks; weight ≤ 1.550g; posnatal age 10-35 days; clinical stability as judged by the ability to tolerate enteral feedings, absence of acquired or congenital infections, minimal requirements for respiratory support and absence of seizures; absence of intraventricular haemorrhage above grade II; and no history of haemolytic anaemia. The prematures were randomised in three groups: group I, control, did not receive rHu-epo; group II received rHu-epo(EPREXR-Cilag - Biotecnologia, Br), subcutaneously, at a dose of 700 UI/kg twice a week; and group III received same dose per week every day. Supplemental oral iron (6 mg/kg/day) and vitamin E (20mg/kg/day) was ordered for all infants. Complete blood count, reticulocytes, serum ferritin, weight and height were obtained at the beginning and weekly during the study. The rHu-epo was administered until discharge, usually when 2000g of weight was reached.
