High Prevalence of Iron Deficiency Despite Standardized High-Dose Iron Supplementation During Recombinant Erythropoietin Therapy in Extremely Low Gestational Age Newborns.
Anemia, Iron-Deficiency
/ blood
Drug Therapy, Combination
Erythropoietin
/ therapeutic use
Female
Ferrous Compounds
/ therapeutic use
Hematinics
/ administration & dosage
Humans
Infant, Extremely Premature
Infant, Newborn
Iron-Dextran Complex
/ administration & dosage
Male
Prevalence
Recombinant Proteins
/ therapeutic use
Retrospective Studies
erythropoietin
extremely low gestational age neonates
iron
iron deficiency
serum ferritin
transferrin saturation
Journal
The Journal of pediatrics
ISSN: 1097-6833
Titre abrégé: J Pediatr
Pays: United States
ID NLM: 0375410
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
13
11
2019
revised:
25
03
2020
accepted:
25
03
2020
pubmed:
19
5
2020
medline:
26
11
2020
entrez:
19
5
2020
Statut:
ppublish
Résumé
To assess the effects of protocolized recombinant human erythropoietin (r-HuEPO) therapy and standardized high dose iron supplementation on hematologic and iron status measures in a cohort of extremely low gestational age newborns (ELGANs). Charts of extremely low gestational age newborns admitted from 2006 to 2016 and who had received r-HuEPO per neonatal intensive care unit protocol were reviewed. The r-HuEPO was started at a dose of 900 IU/kg per week after 7 days of age and continued until 35 weeks postmenstrual age. Oral iron supplementation at 6-12 mg/kg per day was used to maintain a transferrin saturation of >20% during r-HuEPO treatment. Data on demographic features, hematologic and iron panel indices, red blood cell transfusions, and clinical outcomes were collected. Quartile groups were created based on serum ferritin levels at the conclusion of the r-HuEPO treatment and the quartiles were compared. The cohort included 116 infants with mean gestational age 25.8 ± 1.5 weeks and birth weight 793 ± 174.1 g. The r-HuEPO promoted erythropoiesis as indicated by increasing hemoglobin, hematocrit, and reticulocyte count. Serum ferritin decreased over time and was ≤75 ng/mL in 60.2% of infants at the conclusion of r-HuEPO therapy; 87% received packed red blood cell transfusions. Transfusion volume, total iron intake, total iron binding capacity, and transferrin concentration differed among infants in the different serum ferritin quartiles (P < .05). In extremely low gestational age newborns, r-HuEPO therapy promoted erythropoiesis. Despite a biomarker-based standardized high-dose iron supplementation, the majority of infants had evidence of iron deficiency to a degree that is associated with reduced brain function.
Identifiants
pubmed: 32418819
pii: S0022-3476(20)30434-0
doi: 10.1016/j.jpeds.2020.03.055
pmc: PMC7461620
mid: NIHMS1581663
pii:
doi:
Substances chimiques
EPO protein, human
0
Ferrous Compounds
0
Hematinics
0
Recombinant Proteins
0
Erythropoietin
11096-26-7
ferrous sulfate
39R4TAN1VT
Iron-Dextran Complex
9004-66-4
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
98-105.e3Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR002494
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
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