The majority of neonates with Rh-isoimmunization develops late anemia between the
second and the sixth week of life. We report the effectiveness of recombinant
human erythropoietin (rHuEPO) in preventing late anemia in 25 intrauterine and
nonintrauterine-transfused neonates. The neonates were treated from 11+/-4 days
after birth to 26+/-14 days (400 U/kg/d of rHuEpo, administered subcutaneously).
During rHuEpo therapy, vitamin E, calcium folinate, and iron maltose were
administered intramuscularly on a daily basis. Hematocrit, platelet, and
neutrophil counts did not differ significantly before and after 21-days therapy.
However, average values for reticulocyte showed a significant increase. The
hematocrit values in the non-intrauterine transfusion (IUT) group increased
progressively from the beginning to the end of the treatment, whereas that in the
IUT group remained stable. Reticulocyte count increased during treatment in both
groups, but it was significantly elevated in the non-IUT group only. Moreover, we
observed that only neonates transfused with IUTs needed transfusions before and
after treatment. This study suggests the effectiveness of rHuEpo therapy in the
treatment of neonates with Rh-isoimmunization and it highlights how IUTs decrease
the neonatal response efficacy. Larger, better if multicentric, randomized
controlled trial are needed to definitely state whether rHuEPO safely decreases
the incidence of late onset anemia.