***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In vitro and animal studies suggest that high concentrations of recombinant human erythropoietin ( rHuEPO ) might divert multipotent progenitors into erythroid maturation at the expense of granulocyte production . We determined whether changes of number and lineage commitment of peripheral blood progenitor cells occur in premature infants during therapy with rHuEPO .  Thirty preterm infants were r and omly assigned either to receive 300 IU of eopoetin alpha s.c . per kilogram body weight three times a week for four weeks or to a control group . At study entry and after two weeks of treatment the numbers of circulating BFU-E , granulocyte-macrophage colony-forming units ( CFU-GM ) and granulocyte-erythrocyte-macrophage-megakaryocyte CFU ( CFU-GEMM ) were analyzed by semisolid culture technique , CD34 + cells and early myeloid CD34+CD45RA- progenitors by flow cytometry . As compared with the control group , rHuEPO treatment did not exert any significant modulatory effect on numbers of CFU-GM , nor was there a significant change in numbers of BFU-E , CFU-GEMM , total-CFU , percentage of CD34 + or CD34+CD45RA- cells . Mean neutrophil count was not significantly reduced at any period during the study . Compared with the control group , the infants receiving rHuEPO had higher hematocrit values ( p = 0.003 ) and absolute reticulocyte counts ( p < 0.001 ) . The median cumulative volume of blood transfused per kilogram per day was 0.86 ml ( first quartile 0.5 ml ; third quartile 1.1 ml ) in the control group and 0 ml ( first quartile 0 ml ; third quartile 0.47 ml ) in the rHuEPO group ( p = 0.038 ) . We conclude using a relatively high dose of rHuEPO in premature infants , no significant in vivo effect on circulating peripheral blood progenitor or neutrophil count could be detected In addition to its hematopoietic effects , erythropoietin causes an increased release of endothelin-1 and the stimulation of angiogenesis and thereby it may have possible role in development of  retinopathy of prematurity ( ROP ) . Our objective was to determine if an association exists between recombinant human erythropoietin ( rhEPO ) treatment and the development of ROP . Our case-control study involved 85 very low birthweight infants with birthweights < 1500 g born during 2003 and 2004 . All the infants were divided into two groups on the basis of whether they got rhEPO or not . The rhEPO was given at the dose of 200 to 250 units/kg/dose three times a week for 10 doses . Further duration of rhEPO therapy was decided on the basis of the clinical response . Ophthalmological examinations were done at the age of 5 to 6 weeks and were repeated 1 to 4 weeks after the first examination according to the severity of the ROP disease during their in-hospital stay . Of 85 infants , 56 ( 66 % ) received rhEPO and 29 ( 34 % ) did not . In the rhEPO-treated group , 12 infants ( 21 % ) had ROP ; in the non-rhEPO group , 11 infants ( 38 % ) developed ROP . This difference is not statistically significant ( odds ratio = 2.63 ; P = 0.10 ) . There was no correlation between the use of rhEPO and the stage of ROP ( r and om sample = -0.01 ; P = 0.89 ) . There was no significant difference in the incidence of plus , prethreshold , or threshold disease and the treatment required for ROP between the rhEPO-treated and the nontreated group . The study showed there is no significant difference in the incidence and severity of ROP between the rhEPO-treated and nontreated group BACKGROUND : We previously reported decreased transfusions and donor exposures in preterm infants r and omized to Darbepoetin ( Darbe ) or erythropoietin ( Epo ) compared with placebo . As these erythropoiesis-stimulating agents ( ESAs ) have shown promise as neuroprotective agents , we hypothesized improved neurodevelopmental outcomes at 18 to 22 months among infants r and omized to receive ESAs . METHODS : We performed a r and omized , masked , multicenter study comparing Darbe ( 10 μg/kg , 1 × /week subcutaneously ) , Epo ( 400 U/kg , 3 × /week subcutaneously ) , and placebo ( sham dosing 3 × /week ) given through 35 weeks ’ postconceptual age , with transfusions administered according to a st and ardized protocol . Surviving infants were evaluated at 18 to 22 months ’ corrected age using the Bayley Scales of Infant Development III . The primary outcome was composite cognitive score . Assessment s of object permanence , anthropometrics , cerebral palsy , vision , and hearing were performed . RESULTS : Of the original 102 infants ( 946 ± 196 g , 27.7 ± 1.8 weeks ’ gestation ) , 80 ( 29 Epo , 27 Darbe , 24 placebo ) returned for follow-up . The 3 groups were comparable for age at testing , birth weight , and gestational age . After adjustment for gender , analysis of covariance revealed significantly higher cognitive scores among Darbe ( 96.2 ± 7.3 ; mean ± SD ) and Epo recipients ( 97.9 ± 14.3 ) compared with placebo recipients ( 88.7 ± 13.5 ; P = .01 vs ESA recipients ) as was object permanence ( P = .05 ) . No ESA recipients had cerebral palsy , compared with 5 in the placebo group ( P < .001 ) . No differences among groups were found in visual or hearing impairment . CONCLUSIONS : Infants r and omized to receive ESAs had better cognitive outcomes , compared with placebo recipients , at 18 to 22 months . Darbe and Epo may prove beneficial in improving long-term cognitive outcomes of preterm infants ABSTRACT : To assess whether erythropoietin ( EPO ) treatment is safe and reduces the need for transfusion , we r and omized 44 preterm infants to an EPO group and a comparable control ( CON ) group .  EPO 150 U/kg was given s.c . twice weekly for 6 wk from the 1st wk of life . Hematologic parameters , transfusion requirements , and growth were followed during therapy and for 6 mo thereafter . To better assess in which neonates EPO treatment was effective , we classified retrospectively the EPO and CON groups into uncomplicated neonates ( EPO A : n = 9 , birth weight = 1247 ± 126 g , gestational age = 29.8 ± 1.5 wk ; CON A : n = 7 , birth weight = 1217 ± 145 g , gestational age = 29.9 ± 1.5 wk ) and neonates requiring artificial ventilation ( EPO B : n = 16 , birth weight = 1169 ± 249 g , gestational age = 28.1 ± 2 wk ; CON B : n = 12 , birth weight = 1173 ± 215 g , gestational age = 28.3 ± 2 wk ) . There were significant differences in reticulocytes between both uncomplicated and ventilated neonates in the EPO group compared with respective control groups . However , the need for transfusion was significantly less in the uncomplicated EPO group ( EPO A : 0.44 ± 0.73 versus CON A : 1.28 ± 0.75 , p < 0.05 ) but not in the neonates on ventilation ( EPO B : 8.25 ± 5 versus CON B : 7.75 ± 3.7 ) . In conclusion , early EPO administration reduces the need for transfusion in uncomplicated premature neonates . Although stimulation of erythropoiesis was apparent in both uncomplicated and complicated neonates , the end- result of increased need for transfusion in complicated neonates was related to altered indication of transfusion . These infants probably require further or longer EPO administration after weaning from ventilation and improvement of clinical condition OBJECTIVE To study the efficacy , safety and cost effectiveness of recombinant human erythropoietin ( r-HuEPO ) in reducing erythrocyte transfusion needs in very low birthweight ( VLBW ) infants . METHODS We conducted a non-blind r and omized controlled trial and assigned 100 VLBW infants , less than 33 weeks gestation , to receive either r-HuEPO 750 U/kg per week subcutaneously from day 5 to day 40 or no erythropoietin ( EPO ) . Infants received oral iron 3 - 6 mg/kg per day from day 10 . Transfusion needs were analysed for all enrolled infants and in five weight subgroups : birthweight of less than 600 g , 600 - 799 g , 800 - 999 g , 1000 - 1199 g and infants more than 1200 g. RESULTS VLBW infants on r-HuEPO attained higher reticulocyte counts and haematocrit than control infants but the mean number of transfusions and volume of erythrocyte transfused per infant were not statistically different . Of infants 800 - 999 g at birth , the mean number of transfusions per infant was 2.1 compared with 3.5 transfusions per control infant ( P = 0.04 ) . Volume of erythrocytes transfused was 34.9 + /- 32.1 mL/kg in r-HuEPO-treated infants and 56.6 + /- 25.8 mL/kg in control infants ( P = 0.03 ) . The cost per patient for transfusion and EPO was S$388 for r-HuEPO recipient and S$438 for control infant . Blood pressure , neutrophil count , platelet count and complications of prematurity were not significantly different in both groups of VLBW infants . CONCLUSION r-HuEPO at 750 U/kg per week stimulates erythropoiesis in VLBW infants but significantly reduces the need for erythrocyte transfusion only in infants weighing 800 - 999 g at birth OBJECTIVE : The purpose of this study was to evaluate the efficacy and safety of erythropoietin in neonatal hypoxic-ischemic encephalopathy ( HIE ) , by using a r and omized , prospect i ve study design . METHODS : A total of 167 term infants with moderate/severe HIE were assigned r and omly to receive either erythropoietin ( N = 83 ) or conventional treatment ( N = 84 ) . Recombinant human erythropoietin , at either 300 U/kg ( N = 52 ) or 500 U/kg ( N = 31 ) , was administered every other day for 2 weeks , starting < 48 hours after birth . The primary outcome was death or disability . Neurodevelopmental outcomes were assessed at 18 months of age . RESULTS : Complete outcome data were available for 153 infants . Nine patients dropped out during treatment , and 5 patients were lost to follow-up monitoring . Death or moderate/severe disability occurred for 35 ( 43.8 % ) of 80 infants in the control group and 18 ( 24.6 % ) of 73 infants in the erythropoietin group ( P = .017 ) at 18 months . The primary outcomes were not different between the 2 erythropoietin doses . Subgroup analyses indicated that erythropoietin improved long-term outcomes only for infants with moderate HIE ( P = .001 ) and not those with severe HIE ( P = .227 ) . No negative hematopoietic side effects were observed . CONCLUSION : Repeated , low-dose , recombinant human erythropoietin treatment reduced the risk of disability for infants with moderate HIE , without apparent side effects OBJECTIVE This is a repeat cohort study in which we sought to determine whether an association of necrotizing enterocolitis ( NEC ) < 48 hours of a packed red blood cells ( PRBC ) transfusion was a prior sampling artifact . STUDY DESIGN All very low birth weight neonates with NEC Stage ≥ IIB admitted over an 18-month period were categorized for NEC : ( 1 ) < 48 hours after a PRBC transfusion ; ( 2 ) unrelated to the timing of PRBCs ; and ( 3 ) never transfused . RESULTS Eight hundred eighty-three admissions over 18 months were review ed ; 256 were very low birth weight that result ed in 36 NEC cases and 25 % were associated with PRBC ( n = 9 ) . PRBC-associated cases had lower birth weight , hematocrit , and rapid onset of signs ( < 5 hours ) . The timing of association of  PRBC transfusion and NEC differed from r and om , showing a distribution that was not uniform over time ( χ(2 ) = 170.7 , df = 40 ; P < .000001 ) consistent with the possibility of a causative relationship in certain cases of NEC . Current weight at onset of NEC did not 
    Output:
    
Early administration of EPO reduces the use of RBC transfusions , the volume of RBCs transfused , and donor exposure after study entry .