Elsevier

The Journal of Pediatrics

Volume 123, Issue 6, December 1993, Pages 996-1000
The Journal of Pediatrics

A randomized, double-blind, placebo-controlled trial of recombinant erythropietin in treatment of the anemia of bronchopulmonary dysplasia

https://doi.org/10.1016/S0022-3476(05)80401-9Get rights and content

Because anemia in patients with bronchopulmonary dysplasia is characterized by inappropriately low serum concentrations of erythropoletin but increased in vitro sensitivity of erythrold progenitors to erythropoletin, we speculated that administration of human recombinant erythropoletin would correct this anemia. Fifteen infants with the anemia of bronchopulmonary dysplasia were randomly assigned to recelve erythropoietin or placebo subcutaneously for 10 days. Changes in reticulocyte count, hematocrit, blood lactate concentration, neutrophil count, platelet count, heart rate, oxygen requirement, weight gain, and number of transfusions were assessed. In the 10 erythropoietin recipients (99±12 days of age), hematocrit values increased from 0.325±0.006 to 0.381±0.013 (mean ± SEM; p<0.005) and reticulocyte counts from 122±20 to 446±48×103/μl (p<0.005); lactate values remained unchanged. In the five placebo recipients (91±12 days of age), hematocrits and reticulocyte counts remained unchanged, and lactate values increased from 0.73±0.14 to 1.34±0.25 μmol/gm (p<0.05). During the 30 days after the treatment period, one erythropoietin recipient and four placebo recipients were given transfusions. Other measured variables remained unchanged in both groups. We conclude that erythropoletin is effective in treatment of the anemia of bronchopulmonary dysplasia.

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    Citation Excerpt :

    This anemia was initially described by Alverson et al3 and subsequently characterized by Christensen and colleagues17 as a normocytic, normochromic, hyporegenerative anemia with marrow normoblast iron stains that are distinct from those observed in the anemia of chronic disorders and the anemia of prematurity. Patients with the anemia of bronchopulmonary dysplasia treated with Epo had increased reticulocytes and hematocrits, and required fewer transfusions than placebo recipients.56 Factors that likely play a role in this anemia include inflammatory mediators, which create a relatively Epo-resistant environment, such as IL-1, tumor necrosis factor, interferon gamma,38 and common medications that have been associated with decreased Epo concentrations, such as methylzanthines and corticosteroids.5,25,62

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Supported by grants HD-00988, HL-44051, and RR-00064 from the National Institutes of Health and a grant from Primary Children's Medical Center Foundation.

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