To the Editor.

Ohls et al should be congratulated on successfully completing a difficult clinical trial. The results lead one to reflect on the role, if any, of erythropoietin (Epo) in reducing transfusions in preterm infants. Before we abandon it as a therapy, however, there are at least 2 points that deserve consideration. First, there are no accepted standards to determine phlebotomy losses, yet these, like transfusion guidelines, have a major impact on determining transfusion requirements. For example, a recent Epo study at Middlemore Hospital (Auckland, New Zealand) enrolled 23 infants <1000 g with a similar mean birth weight (779 ± 112 g) and gestation (26 ± 1 weeks) to those in the multicenter study. The mean total blood loss of these infants during their entire hospital stay was only 21.7 ± 7.8 mL compared with 84 ± 55 mL in the Epo group during treatment in...

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