effect of recombinant human erythropoietin on the erythropoiesis of preterm infants

Anemia of prematurity [AOP] is characterized by a low reticulocytic count and a low erythropoietin level, for which many preterm infants receive multiple blood transfusions. The present study investigated whether early treatment of such infants with a low dose of recombinant human erythropoietin [r-HuEPO] would stimulate erythropoiesis and reduce the need for blood transfusion. Twenty preterm infants were enrolled in the study. Ten infants were assigned to receive r-HuEPO in a dose of 150 IU/kg/dose twice weekly for 2 weeks. Ten preterm infants served as a control group. Hematologic measurements, and transfusion requirements were followed for 28 days. The mean hemoglobin and hematocrit levels showed a progressive and significant decrease by days 7, 14 and 28 p<0.0001 in both the study and control groups. However, the level was higher in the r-HuEPO treated group throughout the study. The corrected reticulocytic count on the other hand increased significantly in r-HuEPO treated infants on days 7, 14 and 28 [p<0.0001] while it decreased significantly in the control group. The need for blood transfusion was significantly less in the r-HuEPO treated group. The early use of small dose of r-HuEPO 150 IU/kg twice weekly effectively stimulated erythropoiesis, and reduced the need for blood transfusion in preterm infants

Granulocyte macrophage colony stimulating factor as a marker for neonatal sepsis

To evaluate Granulocyte Macrophage Colony Stimulating Factor [GM-CSF] as an early marker of neonatal sepsis.: forty-five newborn infants of varying gestational age were included in the study. Thirty-five neonates with suspected sepsis [group I] were classified according to the results of blood culture into: subgroup Ia: 17 infants with positive blood culture and subgroup Ib: 18 infants with negative culture. Ten healthy neonates served as control group [group II]. The GM-CSF level was measured in all the studied subjects. Comparison of mean GM-CSF levels by group was accomplished by an analysis of variance.: the mean GM-CSF levels in subgroup Ia was significantly higher than that of subgroup Ib and II. The mean GM-CSF level in subgroup Ib was significantly higher than that in group II. The mean GM-CSF level was 45.76 pg/ml in subgroup Ia, 22.81 pg/ml in subgroup Ib and 6.40 pg/ml in group II [P<0.0001]. The GM-CSF level was positively correlated with the immature or band cell/total neutrophil ratio in subgroup Ia.: GM-CSF level represents a reliable early marker for neonatal infection