Abstract
Background: Premature infants frequently develop anemia. This results from blood sampling and also from a relatively poor erythropoietic response to anemia. As a result, these infants often receive multiple transfusions with the risk of disease transmission. The aim of this study was to determine the efficacy and cost effectiveness of recombinant human erythropoietin (r-HuEPO) in reducing erythrocyte transfusion needs in preterm infants.
Methods: 93 premature infants of gestational age less than 34 weeks and birth weight less than 1500g were admitted in our unit from March 1998 to June 1999 and received r-HuEPO 750 U/kg per week intravenously or subcutaneously from day 5–15 to day 40–55. They also received oral iron 3–6 mg/kg per day from day 10. These infants were compared to 81 iron supplemented premature infants born during 1997 before the protocol r-HuEPO was introduced in 1998.
Results: Gestational age (30.2 vs 30.5), birth weight (BW) (1220 vs 1229g), hemoglobin upon admission (15.6 vs 15.6 g/dl), and phlebotomy losses (20.9 vs 20.2 ml/kg) were similar in both groups. The mean number of transfusions per infant was 0.8 compared with 1.9 transfusions per control infant (p < 0.0001). Volume of erythrocytes transfused was 17.5 mL/kg in r-HuEPO-treated infants and 45.8 mL/kg in control infants (p < 0.0001). The number of infants without transfusion was significantly higher in the r-HuEPO-treated group (64.8 vs 27.2%; p < 0.0001). The cost per patient for transfusion and r-HuEPO was 188 euros for r-HuEPO recipient and 281 euros for control infant. Blood pressure, neutrophil count, platelet count and complications of prematurity were not significantly different in both groups of infants. Of infants with gestational > 32 weeks (18 vs 17 infants) or weight > 1200g at birth (46 vs 57 infants), mean number of transfusions was not significant.
Conclusion: R-HuEPO is cost-effective in the prevention of anemia of prematurity for children born before 32 weeks or with BW < 12000 g. This treatment doesn't exclude other procedures to prevent transfusion requirements.
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Glorieux, I., Tricoire, J., Afchar, N. et al. 97 Cost-Benefit Analysis of Prevention of Neonatal Anemia with Recombinant Human Erythropoietin in Premature Infants. Pediatr Res 56, 480 (2004). https://doi.org/10.1203/00006450-200409000-00120
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DOI: https://doi.org/10.1203/00006450-200409000-00120