Anemia of prematurity is a multifactorial anemia associated with relatively low plasma
erythropoietin levels and insufficient erythropoiesis. Recombinant human erythropoietin
(rhEPO) is used to treat anemia in premature infants. Because ensuring adequate iron
delivery is critical to the success of rhEPO therapy in anemic adults, it is likely
critical to the success of rhEPO in the anemia of prematurity. Results from the clinical
trials of rhEPO in prematurity have shown decreased erythrocyte transfusion numbers,
but not complete elimination of transfusions in most infants. The dosage, route of
administration, and timing of rhEPO therapy in prematurity remain under study. In
addition, the optimal dosage, route of administration, and timing of iron supplementation
necessary to accompany rhEPO therapy remain under investigation.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.
Content published before 2002 is available via pay-per-view purchase only.
Subscribe:
Subscribe to Clinics in PerinatologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Studies in the liver to kidney switch of erythropoietin production.J Clin Invest. 1981; 67: 1183-1188
- Age-dependent expression of the erythropoietin gene in rat liver and kidneys.J Clin Invest. 1992; 89: 753-760
- Serum erythropoietin levels during infancy: associations with erythropoiesis.J Pediatr. 1996; 128: 791-796
- The anemia of prematurity: factors governing the erythropoietin response.N Engl J Med. 1977; 296: 647-650
- Evaluation and treatment of anemia in the neonate.in: Christensen R.D. Hematologic problems of the neonate. W.B. Saunders, Philadelphia2000: 137-169
- At what age does iron supplementation become necessary in low-birth weight infants?.J Pediatr. 1977; 91: 878-883
- Factors related to transfusion in very low birthweight infants treated with erythropoietin.Arch Dis Child. 1996; 74: F182-F186
- Differential diagnosis of anemia.in: Hematology of infancy and childhood. Vol. 1. W.B. Saunders, Philadelphia1993: 346-353
- Iron deficiency in infancy and childhood.N Engl J Med. 1993; 329: 190-193
- Iron deficiency in the weanling: a nutritional problem on the way to resolution.Acta Paediatr Scand Suppl. 1986; 323: 59-67
- Does iron-deficient erythropoiesis in pregnancy influence fetal iron supply?.Acta Obstet Gynecol Scand. 2001; 80: 392-396
- The relationship between decreased iron stores, serum iron and neonatal hypoglycemia in large-for-date newborn infants.Acta Paediatr Scand. 1989; 78: 538-543
- Cord transferrin and ferritin values in newborn infants at risk for prenatal uteroplacental insufficiency and chronic hypoxia.J Pediatr. 1987; 111: 283-286
- Abnormal iron distribution in infants of diabetic mothers: spectrum and maternal antecedents.J Pediatr. 1990; 117: 455-461
- Iron deficiency of liver, heart, and brain in newborn infants of diabetic mothers.J Pediatr. 1992; 121: 109-114
- Umbilical cord clamping and preterm infants: a randomised trial.BMJ. 1993; 306: 172-175
- The roles and vital importance of placental blood to the newborn infant.J Perinat Med. 1995; 23: 139-141
- Iron requirements of preterm infants.Nutrition. 1994; 10: 77-78
- Iron.in: Fomon S. Nutrition of normal infants. Mosby, St. Louis1993: 239-260
- Erythrocyte incorporation of iron by 56-day-old infants fed a 58Fe-labeled supplement.Pediatr Res. 1995; 38: 373-378
- Erythroctye incorporation and absorption of 58Fe in premature infants treated with erythropoietin.Pediatr Res. 1997; 41: 416-423
- Microminerals in human and animal milks.in: Jensen R. Handbook of milk composition. Academic Press, San Diego1995: 622-674
- Influence of lactoferrin on iron absorption from human milk in infants.Pediatr Res. 1993; 35: 117-124
- Disorders of iron metabolism.N Engl J Med. 1999; 341: 1986-1995
- Cellular and subcellular localization of the Nramp2 iron transporter in the intestinal brush border and regulation by dietary iron.Blood. 1999; 93: 4406-4417
- Nramp2 is mutated in the anemic Belgrade (b) rat: evidence of a role for Nramp2 in endosomal iron transport.Proc Natl Acad Sci USA. 1998; 95: 1148-1153
- Cloning and characterization of a mammalian proton-coupled metal-ion transporter.Nature. 1997; 388: 482-488
- A concise review: iron absorption–the mucin-mobilferrin-integrin pathway. A competitive pathway for metal absorption.Am J Hematol. 1993; 42: 67-73
- Iron homeostasis: new tales from the crypt.Blood. 2000; 96: 4020-4027
- Capacity of the store-regulator in maintaining iron balance.Am J Hematol. 1994; 47: 194-197
- Regulators of iron balance in humans.Blood. 1994; 84: 1697-1702
- A novel iron-regulated protein involved in intracellular iron metabolism.J Biol Chem. 2000; 275: 19906-19912
- A novel duodenal iron-regulated transporter, IREG1, implicated in the basolateral transfer of iron to the circulation.Mol Cell. 2000; 5: 299-309
- The role of transferrin receptors in hemopoietic cell growth.Exp Hematol. 1990; 18: 360-365
- Transferrin receptor is necessary for development of erythrocytes and the nervous system.Nat Genet. 1999; 21: 396-399
- The transferrin receptor: role in health and disease.Int J Biochem Cell Biol. 1999; 31: 1111-1137
- Molecular control of vertebrate iron metabolism: mRNA-based regulatory circuits operated by iron, nitric oxide, and oxidative stress.Proc Natl Acad Sci USA. 1996; 93: 8175-8182
- Evaluation of the mechanism causing anemia in infants with bronchopulmonary dysplasia.J Pediatr. 1992; 120: 593-598
- Serum ferritin in assessment of iron nutrition in healthy infants.Acta Paediatr Scand. 1978; 67: 745-751
- Erythropoietin therapy in neonates at risk of having bronchopulmonary dysplasia and requiring multiple transfusions.J Pediatr. 1996; 129: 89-96
- Decreased ferritin levels, despite iron supplementation, during erythropoietin therapy in anaemia of prematurity.Acta Paediatr. 1996; 85: 496-501
- Erythropoietin, protein and iron supplementation and the prevention of anaemia of prematurity: effects on serum immunoreactive Epo, growth and protein and iron metabolism.Acta Paediatr. 1996; 85: 490-495
- Role of erythropoietin in the newborn.Arch Dis Child. 1993; 69: 273-275
- The effect of epoetin beta (recombinant human erythropoietin) on the need for transfusion in very-low-birth-weight infants.N Engl J Med. 1994; 330: 1173-1178
- A comparison of oral and intravenous iron supplementation in preterm infants receiving recombinant erythropoietin.J Pediatr. 1996; 129: 258-263
- Recombinant human erythropoietin in the treatment of the anemia of prematurity: results of a double-blind, placebo-controlled study.Pediatrics. 1994; 93: 918-923
- Recombinant human erythropoietin stimulates erythropoiesis and reduces erythrocyte transfusions in very low birth weight preterm infants.Pediatrics. 1995; 95: 1-10
- Assessing iron status in children with chronic renal failure on erythropoietin: which measurements should we use?.Pediatr Nephrol. 1994; 8: 51-56
- Erythropoietin, iron and erythropoiesis.Blood. 2000; 96: 823-833
- Effect of low and moderate doses of recombinant human erythropoietin on the haematological response in premature infants on a high protein and iron intake.Eur J Pediatr. 1997; 156: 56-61
- Early rise in serum concentration of transferrin receptor induced by recombinant human erythropoietin in very-low-birth-weight infants.Pediatr Res. 1994; 36: 85-89
- Oral iron is sufficient for erythropoietin treatment of very low birth-weight infants.Eur J Pediatr. 1999; 158: 147-151
- Quantitative assessment of erythropoiesis and functional classification of anemia based on measurements of serum transferrin receptor and erythropoietin.Blood. 1993; 81: 1067-1076
- Serum transferrin receptor as a new index of erythropoiesis.Blood. 1987; 70: 1955-1958
- Early prediction of response to recombinant human erythropoietin in patients with the anemia of renal failure by serum transferrin receptor and fibrinogen.Blood. 1993; 82: 2010-2016
- Serum transferrin receptor levels in the evaluation of iron deficiency in the neonate.Acta Paediatr Jpn. 1995; 38: 455-459
- Plasma transferrin receptor levels and indices of erythropoiesis and iron status in healthy term infants.Am J Pediatr Hematol Oncol. 1997; 20: 309-314
- Transfusions (RBC Tx) and erythropoiesis indicators influence serum transferrin receptors (TfR) levels in premature infants.Pediatr Res. 1995; 37: 282A
- Erythropoietin, protein, and iron supplementation and the prevention of anaemia of prematurity.Arch Dis Child. 1993; 69: 19-23
- Prediction of response to optimize outcome of treatment with erythropoietin.Semin Oncol. 1998; 25: 27-34
- Percentage of hypochromic red blood cells as predictor of erythropoietic and iron response after i.v. iron supplementation in maintenance haemodialysis patients.Nephrol Dial Transplant. 1997; 12: 1173-1181
- The use of zinc protoporphyrin in screening young children for iron deficiency.Clin Pediatr. 1994; : 473-479
National Kidney Foundation. Clinical practice guidelines for the treatment of anemia of chronic renal failure. Available at: http://www.kidney.org/doqi.angl.html. 1999.
- Erythropoietin and iron.Kidney Int. 1999; 55: S49-S56
- Current practice and guidelines for the transfusion of cellular blood components in the newborn.Trans Med Rev. 1989; 3: 39-54
- Transfusion therapy in neonates.Am J Dis Child. 1991; 145: 904-911
- Lactate levels in r-HuEpo treated infants during the anemia of prematurity.Pediatr Res. 1995; 37: 279A
- The relationship between determinants of oxygen delivery and respiratory abnormalities in anemic preterm infants.J Pediatr. 1992; 120: 292-296
- Blood transfusion effect on the respiratory pattern of preterm infants.Pediatrics. 1987; 80: 79-84
- Assessing the need for transfusion of premature infants and role of hematocrit, clinical signs, and erythropoietin level.Pediatrics. 1989; 84: 412-417
- Do cardiac output and serum lactate levels indicate blood transfusion requirements in anemia of prematurity?.Intensive Care Med. 1996; 22: 472-476
- A randomized trial to develop criteria for administering erythrocyte transfusion to anemic preterm infants 1 to 3 months of age.J Perinatol. 1989; 9: 246-253
- Total circulating red cells versus haematocrit as the primary descriptor of oxygen transport by the blood.Br J Haematol. 1990; 288: 294
- Changing practices of red blood cell transfusions in infants with birth weights less than 1000 g.J Pediatr. 2000; 136: 220-224
- Erythropoietin to prevent and treat the anemia of prematurity.Curr Opin Pediatr. 1999; 11: 108-114
- The effects of early erythropoietin therapy on the transfusion requirements of preterm infants below 1250 grams birthweight: a multicenter, randomized controlled trial.Pediatrics. 2001; 108: 934-942
- Practice parameter for the use of red blood cell transfusions.Arch Pathol Lab Med. 1998; 122: 130-138
- Changing patterns of red blood cell transfusion in very low birth weight infants.J Pediatr. 1996; 129: 680-687
- Score for neonatal acute physiology predicts erythrocyte transfusions in premature infants.Arch Dis Pediatr Adolesc Med. 1997; 151: 27-31
- Serum ferritin levels in preterm infants after multiple blood transfusions.Am J Perinatol. 1988; 5: 40-43
- Effect of transfusion and phlebotomy on serum ferritin levels in low birth weight infants.J Perinatol. 1996; 16: 39-42
- Iron Absorption by the premature infant: the effect of transfusion and iron supplements on the serum ferritin levels.Acta Paediatr Scand Suppl. 1982; 299: 83-89
- Iron deficient erythropoiesis in premature infants measured by blood zinc protoporphyrin/heme.J Pediatr. 2001; 139: 134-136
- Effect of early versus late administration of human recombinant erythropoietin on transfusion requirements in premature infants: results of a randomized, placebo-controlled, multicenter trial.Pediatrics. 2000; 105: 1066-1072
- Double blind trial of recombinant human erythropoietin in preterm infants—comment.Arch Dis Child. 1993; 69: 542
- Recombinant human erythropoietin therapy for treatment of anemia of prematurity in very low birth weight infants: a randomized, double-blind, placebo-controlled trial.J Perinatol. 1998; 18: 173-177
- The effect of erythropoietin on the transfusion requirements of preterm infants weighing 750 grams or less: a randomized, double-blind, placebo-controlled study.J Pediatr. 1997; 131: 661-665
- Follow-up of very low birth weight infants after erythrpoietin treatment to prevent anemia of prematurity.J Pediatr. 1995; 127: 291-297
- Effect of recombinant human erythropoietin in preterm infants.Eur J Haematol. 1999; 63: 71-76
- Single-dose pharmacokinetics of recombinant human erythropoietin in preterm infants after intravenous and subcutaneous administration.J Pediatr. 1993; 122: 655-657
- Erythropoietin pharmacokinetics in premature infants: developmental, non-linearity, and treatment effects.J Appl Physiol. 1996; 80: 140-148
- Pharmacokinetics and effectiveness of recombinant erythropoietin administered to preterm infants by continuous infusion in total parenteral nutrition solution.J Pediatr. 1996; 128: 518-523
- Early treatment of premature infants with recombinant human erythropoietin.Pediatrics. 1993; 92: 519-523
- Meta-analysis of controlled clinical trials studying the efficacy of rHuEPO in reducing blood transfusions in the anemia of prematurity.Transfusion. 2001; 41: 406-415
- A multicenter randomized double-masked placebo-controlled trial of early erythropoietin and iron administration to preterm infants.Ped Res. 1999; 45: 216A
- Iron supplementation enhances response to high doses of recombinant human erythropoietin in preterm infants.Arch Dis Child. 1998; 79: F44-F48
- Effect of high doses of human recombinant erythropoietin on the need for blood transfusions in preterm infants.J Pediatr. 1992; 121: 98-102
- Effect of intravenous iron supplementation on erythropoiesis in erythropoietin-treated premature infants.Pediatrics. 2001; 107: 78-85
- The role of high-dose oral iron supplementation during erythropoietin therapy for anemia of prematurity.J Perinatol. 2001; 21: 215-220
- Bleomycin-detectable iron in the plasma of premature and full-term neonates.FEBS Lett. 1992; 303: 210-212
- A novel method for measuring antioxidant capacity and its application to monitoring the antioxidant status in premature neonates.Clin Sci. 1993; 84: 407-412
- Iron, plasma antioxidants and the oxygen radical disease of prematurity.Am J Dis Child. 1988; 142: 1341-1344
- High- versus low-dose erythropoietin in extremely low birth weight infants.J Pediatr. 1998; 132: 866-870
- Blood transfusion in the neonate: effects of dilution and age of blood on hemolysis.J Pediatr. 1982; 101: 605-607
- The effects of transfusions on oxidative stress and plasma erythropoietin levels in premature infants.Ann Hematol. 2000; 79: B13
Article info
Identification
Copyright
© 2002 Elsevier Science (USA). Published by Elsevier Inc. All rights reserved.
