Anaemia of prematurity: treatment with erythropoietin

Anemia of prematurity is a hyporegenerative anemia usually appearing after the second week, reaching highest intensity in the second month of life. It's normocytic and normochromic with low reticulocyte count. It has been attributed to EPO deficiency. The low EPO levels detected in premature infants and the proper response to synthetic erythropoietin suggested that EPO administration in premature of < or =32 weeks gestational age could be of benefit trying to maintain or increase the hematocrit levels. Protocols of EPO administration to premature babies should always be considered as EPO+Fe, keeping ferritin levels over 100 ng/ml. Failures to EPO+Fe treatment in very small premature babies, measured as no decrease in the need of blood transfusions, may be due to the amount of blood looses that should be restricted.