Early treatment with erythropoietin beta ameliorates anemia and reduces transfusion requirements in infants with birth weights below 1000 g

J Pediatr. 2002 Jul;141(1):8-15. doi: 10.1067/mpd.2002.124309.


Objective: To investigate whether recombinant erythropoietin (rhEPO) reduces the need for transfusion in extremely low birth weight (ELBW) infants (birth weight 500-999 g) and to determine the optimal time for treatment.

Methods: In a blinded multicenter trial, 219 ELBW infants were randomized on day 3 to one of 3 groups: early rhEPO group (rhEPO from the first week for 9 weeks, n = 74), late rhEPO group (rhEPO from the fourth week for 6 weeks, n = 74), or control group (no rhEPO, n = 71). All infants received enteral iron (3-9 mg/kg/day) from the first week. The rhEPO beta dose was 750 IU/kg/week. Success was defined as no transfusion and hematocrit levels never below 30%.

Results: Success rate was 13% in the early rhEPO group, 11% in the late rhEPO group, and 4% in the control group (P =.026 for early rhEPO versus control group). Median transfusion volume was 0.4 versus 0.5 versus 0.7 mL/kg/day (P =.02) and median donor exposure was 1.0 versus 1.0 versus 2.0 (P =.05) in the early rhEPO group, the late rhEPO group, and the control group, respectively. Infection risk was not increased and weight gain was not delayed with rhEPO beta.

Conclusion: Early rhEPO beta treatment effectively reduces the need for transfusion in ELBW infants.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Neonatal / drug therapy*
  • Anemia, Neonatal / mortality
  • Blood Transfusion*
  • Cross Infection / epidemiology
  • Double-Blind Method
  • Erythropoietin / therapeutic use*
  • Europe / epidemiology
  • Female
  • Hematocrit
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Iron / metabolism
  • Iron / therapeutic use
  • Male
  • Proportional Hazards Models
  • Recombinant Proteins
  • Statistics, Nonparametric
  • Survival Rate
  • Time Factors


  • Recombinant Proteins
  • Erythropoietin
  • Iron