Erythropoietin: an update on the therapeutic use in newborn infants and children.

Recombinant human erythropoietin (epoetin) has become the most widely used cytokine in the world. Following the success of its use in patients with end-stage renal disease, the usefulness of epoetin in other anaemias was assessed, including paediatric patients, mainly newborns. The treatment or prevention of anaemia of prematurity with epoetin resulted in a significant reduction in the number of transfusions and donor exposure. A clear definition of which premature babies must receive therapy is yet to be established. Other indications in neonatal period include hyporegenerative and haemolytic anaemias. The potential for use of the nonhaematopoietic effects of epoetin in newborn infants is a novel and exciting issue. The role of epoetin as a tissue-protective factor for the CNS and intestinal mucosa is under exhaustive investigation. With the exception of chronic renal failure, in older children the efficacy of epoetin has not been evaluated as in adults. Although an impressive amount of studies were carr...