Effects of Recombinant Human Erythropoietin in Infants with Very Low Birth Weights

1996 ◽  
Vol 24 (2) ◽  
pp. 190-198 ◽  
Author(s):  
N Samanci ◽  
F Ovali ◽  
T Da͂o͂lu
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Day Treatment ◽  
Haemoglobin Concentration ◽  
The Third ◽  
Human Erythropoietin ◽  
Erythropoietin Production ◽  
End Of Treatment ◽  
Anaemia Of Prematurity ◽  
Oral Supplements ◽  
To Receive

Anaemia of prematurity, a postnatal fall in haemoglobin concentration and haematocrit, is particularly common in those born at less than 32 weeks of gestation. Experimental and clinical data implicate inadequate erythropoietin production as an important reason. In this study recombinant human erythropoietin (r-HuEpo) was used in an attempt to treat or prevent this anaemia and thereby provide an alternative to erythrocyte transfusions. Premature infants (birth weight ≤ 1250 g and gestational age ≤ 32 weeks), who were likely to need transfusions, were randomly assigned to receive 4 weeks of treatment with either subcutaneously administered r-HuEpo (200 U; n = 12) or placebo ( n = 12), three times weekly. All patients had oral supplements of elemental iron at a dose of 3 mg/kg/day. Treatment was started in the third week of life. Reticulocyte counts were significantly raised ( P < 0.05) in the group treated with r-HuEpo at the end of treatment. The neonates in the group treated with r-HuEpo needed fewer erythrocyte transfusions than those in the placebo group during treatment. There were no toxic effects attributable to r-HuEpo. The results indicate that treatment of infants with very low birth weights with r-HuEpo will reduce their need for erythrocyte transfusions

Recombinant human erythropoietin treatment in cisplatin-associated anemia: a randomized, double-blind trial with placebo.

1994 ◽  
Vol 12 (5) ◽  
pp. 1058-1062 ◽  
Author(s):  
S Cascinu ◽  
A Fedeli ◽  
E Del Ferro ◽  
S Luzi Fedeli ◽  
G Catalano
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Saline Solution ◽  
Hemoglobin Level ◽  
Double Blind ◽  
The Third ◽  
Human Erythropoietin ◽  
Transfusion Requirements ◽  
Erythropoietin Treatment ◽  
The Mean ◽  
To Receive

PURPOSE To evaluate the effect of exogenous recombinant human erythropoietin (rHuEPO) on the increase of hemoglobin levels and on the transfusion requirements in patients with cisplatin (CDDP)-induced anemia, we performed a double-blind randomized trial with placebo. PATIENTS AND METHODS One hundred patients with CDDP-associated anemia (hemoglobin level < 90 g/L) were randomized to receive either placebo (saline solution) or rHuEPO (100 U/kg body weight subcutaneously) three times per week. The end points of this study were the increase in hemoglobin levels to greater than 100 g/L after 3, 6, and 9 weeks and the effect on transfusion requirements. RESULTS Ninety-nine of 100 patients were assessable for response and toxicity. In the rHuEPO arm, mean hemoglobin levels were statistically significantly increased after the third, sixth, and ninth weeks of therapy (101.1 +/- 9.0, 102.4 +/- 6.6, and 105.1 +/- 9.4 g/L, respectively) compared with the mean baseline value (86.3 +/- 6.2 g/L). In the placebo arm, there were no increases in mean hemoglobin levels at the third, sixth, and ninth weeks (81.0 +/- 5.2, 81.3 +/- 9.2, and 81.2 +/- 11 g/L, respectively) compared with the mean baseline value (87.3 +/- 5.2 g/L). Furthermore only 20% of patients required blood transfusions in the rHuEPO arm versus 56% of patients in the placebo arm (P = .01), with a mean units of blood transfused per patient of 0.30 in the rHuEPO arm and 1.8 in the placebo arm (P = .01). Treatment was well tolerated, with no significant side effects. CONCLUSION CDDP-induced anemia is corrected by rHuEPO, which results in reduced blood transfusion requirements.

Effect of short term recombinant human erythropoietin (rHuEPO) therapy in the prevention of anemia of prematurity (AOP) in very low birth weight (VLBW) neonates

2013 ◽  
Vol 38 (3) ◽  
pp. 119-123 ◽  
Author(s):  
BHN Yasmeen ◽  
MAKA Chowdhury ◽  
MM Hoque ◽  
MM Hossain ◽  
R Jahan ◽  
...  
Keyword(s):  
Folic Acid ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Recombinant Human Erythropoietin ◽  
Very Low Birth Weight ◽  
Controlled Trial ◽  
Control Group ◽  
Short Term ◽  
Human Erythropoietin ◽  
Anaemia Of Prematurity

Premature infants especially those with birth weight <1500 g suffer from Anaemia of prematurity (AOP) and associated problems. Erythropoietin therapy is a safe effective way to prevent and to treat anaemia of prematurity. To evaluate the effect of short term administration of recombinant human erythropoietin (rHuEPO) with iron and folic acid in very low birth weight (VLBW) neonates in the prevention of anaemia of prematurity. A randomized controlled trial was carried out at Dhaka Shishu Hospital. Sixty preterm very low birth weight (PTVLBW) babies were enrolled in this study. Thirty were assigned to rHuEPO group and 30 as control. Baseline haematologic values were estimated before administration of rHuEPO. From day 7 of life rHuEPO-200 IU/kg/dose subcutaneously every alternate day for 2 weeks was administered to rHuEPO group. All infants in both groups have received oral iron, folic acid from day 14. Clinical and haematological assessment was done at 6 and 10 weeks of life. Baseline clinical characteristics and haematologic values were almost similar in both groups. This study has shown increase in haematological values(haemoglobin and haematocrit) and reduction in the number of blood transfusions during both the 1st and 2nd follow up in rHuEPO group in comparison to control group (p<0.01). Short term rHuEPO appears to be very effective in prevention of Anaemia of prematurity. DOI: http://dx.doi.org/10.3329/bmrcb.v38i3.14340 Bangladesh Med Res Counc Bull 2012; 38(3): 119-123 (December)

scholarly journals Nutrition, anaemia and erythropoietin therapy

1999 ◽  
Vol 3 (2) ◽  
Author(s):  
Iain C. Macdougall
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Ventricular Hypertrophy ◽  
Haemoglobin Concentration ◽  
Left Ventricular ◽  
Dialysis Patients ◽  
Renal Anaemia ◽  
Human Erythropoietin ◽  
Cardiovascular Morbidity And Mortality ◽  
Objective Evidence

During the last decade, recombinant human erythropoietin has revolutionised the management of renal anaemia. It is highly effective in the vast majority of patients treated, causing enhanced erythropoiesis and a rise in haemoglobin concentration. This has resulted not only in amelioration of uraernic symptoms, but there has also been objective evidence of improved quality-of-life, exercise capacity, and cardiac function [I]. The most striking benefits seen have been progression of left ventricular hypertrophy which is known to account for much of the high cardiovascular morbidity and mortality seen in dialysis patients. and thus the arguments for correcting renal anaemia is now overwhelming. There is also an improvement in nutrition following erythropoietin therapy, over and above the improvement in appetite associated with correction of the anaemia.

Haemostatic Effects of Recombinant Human Erythropoietin in Chronic Haemodialysis Patients

1989 ◽  
Vol 61 (01) ◽  
pp. 117-121 ◽  
Author(s):  
Chris van Geet ◽  
Didier Hauglustaine ◽  
Luc Verresen ◽  
Marleen Vanrusselt ◽  
Jos Vermylen
Keyword(s):  
Platelet Count ◽  
Recombinant Human Erythropoietin ◽  
Bleeding Time ◽  
Chronic Haemodialysis ◽  
Recombinant Erythropoietin ◽  
The Third ◽  
Human Erythropoietin ◽  
Platelet Number ◽  
Almost All ◽  
And Function

SummaryRecombinant human erythropoietin was administered for up to 40 weeks to nine patients on chronic haemodialysis. From the third week of administration onwards, not only haemoglobin and haematocrit but also the platelet count rose, the latter, however, transiently. Subnormal platelet aggregation before therapy also improved transiently and in parallel with the erythropoietin dosage. The bleeding time normalized in almost all patients. There were no major side-effects. We conclude that recombinant erythropoietin improves haemostasis in chronic haemodialysis patients by increasing the haematocrit and in addition transiently enhances platelet number and function.

scholarly journals Evaluation of Recombinant Human Erythropoietin Responsiveness by Erythrocyte Creatine in Haemodialysis Patients

2021 ◽  
Author(s):  
Shun Hasegawa ◽  
Seishi Nakamura ◽  
Tetsuro Sugiura ◽  
Yoshiaki Tsuka ◽  
Nobuyuki Takahashi ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Rapid Change ◽  
Haemoglobin Concentration ◽  
Resistance Index ◽  
Important Variable ◽  
Chi Square ◽  
Entire Study ◽  
Human Erythropoietin ◽  
Logistic Analysis ◽  
Erythropoietin Resistance Index

Abstract Background: One of the main causes of anaemia in patients with end-stage renal disease is relative deficiency in erythropoietin production. Recombinant human erythropoietin (rHuEpo), a potent haematopoietic growth factor, is used to treat anaemia in haemodialysis patients. The effect of rHuEpo is usually assessed by haematological indices such as red blood cell count, haemoglobin concentration and haematocrit, but erythrocyte indices do not provide information of the rapid change in erythropoietic activity. As erythrocyte creatine directly assess erythropoiesis, the aim of this study was to evaluate the effect of rHuEpo in haemodialysis patients by measuring erythrocyte creatine. Methods: rHuEpo dose was fixed 3 months prior to the enrollment and was maintained throughout the entire study period. Eerythrocyte creatine was measured with haematologic indices in 83 haemodialysis patients. Haemoglobin was also measured 3 months after. Results: rHuEpo dose (152.4±62.9 vs. 82.2±45.5 units/kg/week, P=0.0001) and erythrocyte creatine (2.07±0.73 vs. 1.60±0.41 µmol/gHb, p=0.0003) were significantly higher in 27 patients with haemoglobin <10g/dL compared to 56 patients with haemoglobin ≥10g/dL. There was a fair correlation between rHuEpo dose and erythrocyte creatine (r=0.55, P <0.0001). Increase in haemoglobin (>0.1g/dL) was observed in 37 patients, whereas haemoglobin did not increase in 46 patients. Erythrocyte creatine was significantly higher in patients with increase in haemoglobin compared to those without (2.04±0.64 vs. 1.52±0.39 µmol/gHb, p <0.0001). When 8 variables (rHuEpo dose, erythropoietin resistance index, C-reactive protein, intact parathyroid hormone, incidence of iron deficiency, presence of anaemia, erythrocyte creatine and reticulocyte) were used in the multivariate logistic analysis, erythrocyte creatine emerged as the most important variable associated with increase in haemoglobin (Chi-square=6.19, P=0.01). Conclusion: Erythrocyte creatine, a useful marker of erythropoietic capacity, is a reliable marker to estimate ameliorative effectiveness of rHuEpo in haemodialysis patients.

scholarly journals Recombinant human erythropoietin in the anemia associated with multiple myeloma or non-Hodgkin's lymphoma: dose finding and identification of predictors of response

Blood ◽  
1995 ◽  
Vol 86 (12) ◽  
pp. 4446-4453 ◽  
Author(s):  
M Cazzola ◽  
D Messinger ◽  
V Battistel ◽  
D Bron ◽  
R Cimino ◽  
...  
Keyword(s):  
Recombinant Human Erythropoietin ◽  
Initial Dosage ◽  
Regression Tree ◽  
Classification And Regression Tree ◽  
Tree Analysis ◽  
Human Erythropoietin ◽  
Regression Tree Analysis ◽  
Predictors Of Response ◽  
Classification And Regression ◽  
To Receive

Previous phase I-II clinical trials have shown that recombinant human erythropoietin (rHuEpo) can ameliorate anemia in a portion of patients with multiple myeloma (MM) and non-Hodgkin's lymphoma (NHL). Therefore, we performed a randomized controlled multicenter study to define the optimal initial dosage and to identify predictors of response to rHuEpo. A total of 146 patients who had hemoglobin (Hb) levels < or = 11 g/dL and who had no need for transfusion at the time of enrollment entered this trial. Patients were randomized to receive 1,000 U (n = 31), 2,000 U (n = 29), 5,000 U (n = 31), or 10,000 U (n = 26) of rHuEpo daily subcutaneously for 8 weeks or to receive no therapy (n = 29). Of the patients, 84 suffered from MM and 62 from low- to intermediate- grade NHL, including chronic lymphocytic leukemia; 116 of 146 (79%) received chemotherapy during the study. The mean baseline Hb level was 9.4 +/- 1.0 g/dL. The median serum Epo level was 32 mU/mL, and endogenous Epo production was found to be defective in 77% of the patients, as judged by a value for the ratio of observed-to-predicted serum Epo levels (O/P ratio) of < or = 0.9. An intention-to-treat analysis was performed to evaluate treatment efficacy. The median average increase in Hb levels per week was 0.04 g/dL in the control group and -0.04 (P = .57), 0.22 (P = .05), 0.43 (P = .01), and 0.58 (P = .0001) g/dL in the 1,000 U, 2,000 U, 5,000 U, and 10,000 U groups, respectively (P values versus control). The probability of response (delta Hb > or = 2 g/dL) increased steadily and, after 8 weeks, reached 31% (2,000 U), 61% (5,000 U), and 62% (10,000 U), respectively. Regression analysis using Cox's proportional hazard model and classification and regression tree analysis showed that serum Epo levels and the O/P ratio were the most important factors predicting response in patients receiving 5,000 or 10,000 U. Approximately three quarters of patients presenting with Epo levels inappropriately low for the degree of anemia responded to rHuEpo, whereas only one quarter of those with adequate Epo levels did so. Classification and regression tree analysis also showed that doses of 2,000 U daily were effective in patients with an average platelet count greater than 150 x 10(9)/L. About 50% of these patients are expected to respond to rHuEpo. Thus, rHuEpo was safe and effective in ameliorating the anemia of MM and NHL patients who showed defective endogenous Epo production. From a practical point of view, we conclude that the decision to use rHuEpo in an individual anemic patient with MM or NHL should be based on serum Epo levels, whereas the choice of the initial dosage should be based on residual marrow function.

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