Criteria for diagnosis and therapy of hyporegeneratory anemia in premature newborns below 33 week of gestation and body weight below 1500 grams

AIM: The aim of the present study is to define criteria for erythropoietin therapy of hyporegeneratory anemia in premature newborns according to hemoglobin (Hb) and hematocrit (Hct) concentration, and reticulocyte count (Ret). MATERIALS AND METHODS: The prospective study includes two groups of 20 newborns with anemia of prematurity, body weight at birth below 1500 grams and gestation age below 33 gestation week. The newborns in the first group have been treated with beta-erythropoietin for four weeks--750-1000 E/kg weekly dose, divided q48h. Hb, Hct and Ret have been monitored and compared with that of control group newborns. The therapy of newborns in the control group consisted of blood transfusions. RESULTS: The hematological parameters in the newborns from the first group have been increased permanently after the first week of therapy, with Ret being most sensitive to the therapy. In the second group of newborns, due to blood transfusions, transient increase of Hb and Hct, and decrease of Ret have been observed in next days after the blood transfusions. CONCLUSIONS: The erythropoietin therapy of hyporegeneratory anemia in preterm newborns leads to rise in Hb, Hct and Ret. The therapy with blood transfusions suppresses erythropoiesis. This leads to decrease in Ret and transient rise in Hb, Hct and erythrocytes. That's why each blood transfusion leads to another one.