Erythropoietin treatment in patients with myelodysplastic syndrome
Keywords:
Anaemia, Myelodysplastic Syndrome, Erythropoietic proteins, Blood transfusionsAbstract
Introduction: Anaemia is frequently diagnosed in patients with
Myelodysplastic Syndrome (MDS) and generally becomes blood
transfusion dependent. The efficacy of treatment with erythropoietic proteins (EPO) in MDS is controversial and the cost/benefit
relationship is being questioned
Objective: To evaluate retrospectively the response to EPO in
patients diagnosed with MDS, followed in our Haemato-oncology
outpatient department.
Method: A retrospective study of all patients, followed over the
last 5 years in the Haemato-oncology outpatient department,
diagnosed with MDS and treated with EPO, were included. We
analyzed demographic parameters, clinical data and treatment.
Results: 5 patients fulfilled the inclusion criteria, four of whom
were males. The average diagnostic age was 73.4 years. In 80%
of cases the patients presented with symptomatic anaemia.
The average Hb. pre-treatment was 9 g/dl. 60% of the patients
responded to the treatment with an average increase of 3.1 g/dl
after 1 month of subcutaneous α-EPO 40.000 UI / weekly. In the
responders group there were no treatment complications and
none needed blood transfusion.
Conclusions: EPO is a therapeutic option in the complicated
approach to MDS. In ours patients 60% responded successfully to
the treatment without complications. Responders did not require blood transfusion
Downloads
References
Heaney ML, Golde DW. Myelodysplasia. N Eng J Med 1999; 340 (21): 1649-1660.
Levine EG, Bloomfield CD. Leukemias and myelodysplastic syndromes secondary to drug, radiation and enviromental exposure. Semin Oncol 1992; 19 (1): 47-84.
Noel P, Solberg LA. Myelodysplastic syndromes. Pathogenesis, diagnosis Pathogenesis, diagnosis and treatment. Crit Rev Oncol Hematol 1992; 12 (3): 193-215.
Bowen D, Culligan D, Jowitt S et al. Guidelines for the diagnosis and therapy of adult myelodysplastic syndromes. Br J Haematol 2003; 120 (2): 187-200.
Hofmann WK, Ottmann OG, Ganser A et al. Myelodysplastic syndromes: clinical features. Semin Hematol 1996; 33: 177-185. Semin Hematol 1996; 33: 177-185.
Greenberg P, Cox C, Le Beau MM et al. International scoring system for International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood 1997; 89 (6): 2079-2088.
NCCN practice guidelines for the myelodysplastic syndromes. Journal of the National Comprehensive Câncer Network 2003; 1: 456-489.
Jensen PD, Heickendorff L, Pedersen B et al. The effect of iron chelation on haemopoiesis in MDS patients with transfusional iron overload. Br J Haematol 1996; 94 (2): 288-299.
Jacobs A, Janowska-Wieczorek A, Caro J et al. Circulating erythropoietin in patients with myelodysplastic syndromes. Br J Haematol 1989; 73 (1): Br J Haematol 1989; 73 (1):36-39.
Rose EH, Abels RI, Nelson RA et al. The use of r-HuEPO in the treatment The use of r-HuEPO in the treatment of anaemia related to myelodysplasia. Br J Haematol 1995; 89 (4): 381-387.
Hellstrom-Lindberg E. Efficacy of erythropoietin in the myelodysplastic syndromes: a meta-analysis of 205 patients from 17 studies. Br J Haematol 1995; 89 (1): 67-71.
Vardiman JW, Harris NL, Brunning RD. The World Health Organization (WHO) classification of the myeloid neoplasms. Blood 2002; 100 (7):
-2302.
Rizzo JD et al. Use of epoietin in patients with cancer: Evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology. Blood 2002;100 (7): 2303-2320.
Musto P, Falcone A, Sanpaolo G et al. Efficacy of a single, weekly dose of recombinant erythropyetin in myelodysplastic syndromes. Br J Haematol Br J Haematol2003; 122 (2): 269-271.
Terpos E, Mougiou A, Kouraklis A et al. Prolonged administration of eryth- Prolonged administration of erythropoietin increases erythroid response rate in myelodysplastic syndromes: a phase II trial in 281 patients. Br J Haematol 2002; 118 (1): 174-180. Br J Haematol 2002; 118 (1): 174-180.
Hellstrom-Lindberg E, Negrin R, Stein R et al. Erythroid response to Erythroid response to treatment with G-CSF plus erythropoietin for the anaemia of patients with myelodysplastic syndromes: proposal for a predictive model. Br J Haematol Br J Haematol 1997; 99 (2): 344-351.
Mantovani L, Lentini G, Hentschel B et al. Treatment of anaemia in myelo Treatment of anaemia in myelodysplastic syndromes with prolonged administration of recombinant human granulocyte colony-stimulating factor and erythropoietin. Br J Haematol Br J Haematol
; 109 (2): 367-375
Additional Files
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
