EFFECTS OF RECOMBINANT-HUMAN-ERYTHROPOIETIN IN INFANTS WITH THE ANEMIA OF PREMATURITY - A PILOT-STUDY
EFFECTS OF RECOMBINANT-HUMAN-ERYTHROPOIETIN IN INFANTS WITH THE ANEMIA OF PREMATURITY - A PILOT-STUDY
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DOI：
10.1016/s0022-3476(05)82671-x
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发表时间：
1990-05-01
影响因子：
5.1
通讯作者：
WYSS, M
中科院分区：
文献类型：
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作者：
HALPERIN, DS;WACKER, P;WYSS, M
为了刺激内源性红细胞生成，从而提供一种替代红细胞输注的方法，我们给7名患有早产儿贫血的婴儿注射了75至300单位/kg/周的重组人红细胞生成素（rHuEpo）。治疗开始于21至33天，维持4周，耐受性良好。所有患者的基线血清促红细胞生成素水平均较低。rHuepo治疗后，网织红细胞数量从平均基线计数的75倍增加。109/L到95、141、165倍。在治疗第7、10、14天分别为109/L。7例患者中有6例观察到贫血得到纠正或稳定，在治疗期间估计红细胞总量增加了49%（而在没有rHuEpo的情况下预计增加18%）。然而，在一名患者中，红细胞压积在治疗期间下降，在三名应答者中，红细胞压积在治疗期间或停药后出现二次下降。在rHuepo治疗开始后，血清铁和铁蛋白水平迅速下降，并且在大多数患者中观察到短暂的早期血小板增多和晚期中性粒细胞减少。这些数据表明rHuEpo可以纠正或稳定早产儿贫血。然而，它的效果可能受到多种因素的限制，其中铁的可用性可能起着重要作用。需要对照研究来证实这些初步观察结果。
In an attempt to stimulate endogenous erythrocyte production and thereby provide an alternative to erthrocyte transfusions, we administered recombinant human erythropoietin (rHuEpo) in doses of 75 to 300 units/kg/wk to seven infants with the anemia of prematurity. Treatment was started between 21 and 33 days of life, maintained for 4 weeks, and was well tolerated. All the patients had low baseline serum erythropoietin levels. After rHuepo therapy, the number of reticulocytes increased from a mean baseline count of 75 .times. 109/L to 95, 141, and 165 .times. 109/L on days 7, 10, and 14 of therapy, respectively. Correction or stabilization of the anemia was observed in six of seven patients, whose estimated total erythrocyte volume increased by 49% during therapy (vs a predicted increment of 18% in the absence of rHuEpo). In one patient, however, the hematocrit declined during the treatment, and in three of the responders a secondary fall in hematocrit was noted either during therapy or after its discontinuation. Serum iron and ferritin levels rapidly decreased after the initiation of rHuepo therapy, and in most patients transient early thrombocytosis and late neutropenia were observed. These data suggest that rHuEpo may correct or stabilize the anemia of prematurity. Its effects, however, may be limited by a variety of factors among which iron availability probably plays an important role. Controlled studies will be needed to confirm these preliminary observations.