in Anemia of prematurity
r-HuEPO has not been widely accepted in clinical neonatology practice because its efficacy is incomplete.
☆On one hand, r-HuEPO and iron effectively stimulate erythropoiesis in vivo as evidenced by increased blood reticulocyte and RBC counts in recipient infants (ie, efficacy successful at the marrow level).
☆On the other hand, when the primary goal of r-HuEPO therapy is to eliminate RBC transfusions, r-HuEPO often fails to do so (ie, efficacy at the clinical level has not been consistently successful).
r-HuEPO although clearly stimulating erythropoiesis in infant marrow, has very limited use, currently, to treat the anaemia of prematurity.
At this time, no agreement regarding the safety, timing, dosing, route, or duration of EPO therapy has been established. In short, the cost-benefit ratio for EPO has yet to be clearly established, and this medication is not universally accepted as a standard therapy for an infant with AOP. “Cochrane review 2020”
Promising but conflicting results related to the neuro protective effect of early EPO require further study. “Cochrane review 2020”
Early treatment with EPO does not alter the risk of death or retinopathy of prematurity and may decrease the risk of neurological damage and damage to the gut. It may also improve long-term outcomes. “Cochrane review 2020”