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KMID : 0367419970400030361
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Journal of Korean Pediatric Society
1997 Volume.40 No. 3 p.361 ~ p.367
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Prophylactic Treatment of Anemia of Prematurity with Recombinant Human Erythropoietin and High Doses of Iron
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이영호
최안홍/이순용/박정숙/최봉근/장형심
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Abstract
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Purpose:Weconductedrandomizedstudytodeterminewhetherhighdoses(6mg/kg/
day)ofiron wouldexertamoresupplementaleffectthan low doses(3mg/kg/day),and
which regimen ofrecombinanthuman erythropoietin(rHuEPO)and iron would bemore
beneficialintheprophylactictreatmentofanemiaofprematurity.
Methods:We randomly assigned 38 sick premature infants who were more likely
thansymptom-freeprematureinfantsrequiringerythrocytetransfusionsforinfantswith
anemia ofprematurity to receive rHuEPO,100unit/kg,tiw,subcutaneously,plus iron,
3mg/kg/day,po,daily from the second day oflife(group 1),100unit/kg and 6mg/kg/
day(group 2),200unit/kg and 3mg/kg/day(group 3),and 200unit/kg and 6mg/kg/day
(group4),respectively.
Results:Therewerenosignificantdifferencesofhemoglobinlevelsandironbalances
duringtreatmentamongall4groups.Theratesofincreaseinreticulocytecountswere
greaterin group 4 and group 2 compared with group 3 and group 1,respectively,
though these rates were statistically not significant.The blood volume differences
(volumeofphlebotomies-volumeoftransfusions)duringtreatmentwerehigheringroup
4comparedwithgroup1(p<0.05).
Conclusions:High dosesofiron may bemoreeffectivein rapidly increasing reticulocytecounts,and200unit/kg,tiw ofrHuEPO plus6mg/kg/dayofironismorebeneficialinreducingtheneedforbloodtransfusionsthananyotherregimen.Thereforethe
prophylactictreatmentofanemiaofprematurityandacutebloodlossfrom frequentblood
samplinginriskyprematureinfantswithrHuEPO,200unit/kg,tiw,subcutaneously,plus
iron 6mg/kg/day,po,daily from the second day oflife is effective in reducing the
numberofblood transfusions.Additionalcontrolled trials utilizing high doses ofiron
withrHuEPO andlargernumbersofpatientsarejustified.
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KEYWORD
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Recombinant Human Erythropoietin, Anemia of Prematurity, Prophylactic Treatment
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