PMID- 38315537
OWN - NLM
STAT- Publisher
LR  - 20240205
IS  - 2385-2070 (Electronic)
IS  - 1723-2007 (Linking)
DP  - 2024 Feb 1
TI  - The role of erythropoietin to prevent red blood cell transfusion in a 2018-2020 
      two-center cohort of preterm infants.
LID - 10.2450/BloodTransfus.641 [doi]
AB  - BACKGROUND: Treatment with recombinant human erythropoietin (rHu-EPO) modestly 
      prevented packed red blood cell transfusions (pRBCTs) in preterm infants in 
      studies performed several years ago. In France, some neonatal units stopped using 
      rHu-EPO, while others continued. The aim of this study was to explore the role of 
      rHu-EPO in the prevention of pRBCTs in a recent cohort of preterm infants. 
      MATERIALS AND METHODS: Preterm infants who met rHu-EPO indications and were 
      hospitalised between 2018 and 2020 in two neonatal units-one that did not use 
      rHu-EPO and another that did-were eligible. Data about the neonatal history, 
      rHu-EPO and iron treatments and pRBCT indications and volumes were collected. 
      Infants exposed and not exposed to rHu-EPO were compared in univariate and 
      multivariate analyses using backward logistic regression and Cox proportional 
      hazards regression. RESULTS: A total of 257 patients exposed to rHu-EPO and 285 
      patients who were not exposed were included. Three profiles emerged. In the 
      infants with a gestational age <28 weeks, the cumulative pRBCT volume/kg was 
      similar regardless of rHu-EPO exposure (mean difference -2.8 mL, 95% confidence 
      interval -16.1, 10.5, p=0.68). In the infants born between 28 and 30 weeks, a 
      late pRBCT was prevented in the rHu-EPO group (single pRBCT: no rHu-EPO 22.1% vs 
      rHu-EPO 8%, p=0.003). However, rHu-EPO was not independently associated with 
      avoidance of this pRBCT. Finally, the need for pRBCT was low in the infants born 
      after 30 weeks of gestation, making rHu-EPO treatment futile. In contrast, early 
      iron supplementation was revealed to be critical in preventing pRBCT. DISCUSSION: 
      No benefit of rHu-EPO in preventing pRBCT was observed in our cohort. The place 
      of rHu-EPO in future requires careful consideration of the population concerned, 
      adjustment of the therapeutic schedule and evolution of the indications for 
      pRBCT.
FAU - Bailly, Noemie
AU  - Bailly N
AD  - Department of Neonatology, Tours University Hospital, Tours, France.
FAU - Brat, Roselyne
AU  - Brat R
AD  - Department of Neonatology, Orleans University Hospital, Orleans, France.
FAU - Favrais, Geraldine
AU  - Favrais G
AD  - Department of Neonatology, Caen University Hospital, Universite de Caen 
      Normandie, UFR Medecine, Caen, France.
LA  - eng
PT  - Journal Article
DEP - 20240201
PL  - Italy
TA  - Blood Transfus
JT  - Blood transfusion = Trasfusione del sangue
JID - 101237479
SB  - IM
EDAT- 2024/02/05 14:44
MHDA- 2024/02/05 14:44
CRDT- 2024/02/05 11:53
PHST- 2023/09/11 00:00 [received]
PHST- 2024/01/15 00:00 [accepted]
PHST- 2024/02/05 14:44 [medline]
PHST- 2024/02/05 14:44 [pubmed]
PHST- 2024/02/05 11:53 [entrez]
AID - BloodTransfus.641 [pii]
AID - 10.2450/BloodTransfus.641 [doi]
PST - aheadofprint
SO  - Blood Transfus. 2024 Feb 1. doi: 10.2450/BloodTransfus.641.