Τίτλος:
Treatment of anemia in low-risk myelodysplastic syndromes with
amifostine. In vitro testing of response
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Amifostine (AMF) promotes in vitro growth and survival of hematopoietic
progenitors. In this study we evaluated the efficacy of AMF in the
treatment of anemia in patients with low-risk myelodysplastic syndromes
(MDS) and the possible predicting value for response to AMF therapy of
two types of in vitro clonogenic assays. Two different doses of AMF, 300
mg/m(2) (group A, 11 patients) or 400 mg/m(2) (group B, 16 patients),
were studied. AMF was given three times weekly for 3 weeks, i.v.,
followed by 2 weeks off therapy. Patients were evaluated after two
cycles of treatment. Partially or nonresponding patients of group A
received 400 mg/m(2) AMF and were reevaluated. An increase of hemoglobin
(Hb) values of more than 2 g/dl and a 100% decrease in transfusion
requirements for at least 6 weeks were defined as a complete response
(CR) while an increase of Hb values of 1-2 g/dl or a 50% decrease in
transfusion requirements was considered as a partial response (PR). In
group A, two out of 11 (18.1%) patients achieved a CR with the initial
dose and one of the nine that received 400 mg/m(2) AMF achieved a PR. In
group B, three out of 16 (18.7%) patients achieved a PR; the overall
response rate in both groups was 22.2%. In group A, bone marrow
progenitor assay was performed pre- and post-amifostine treatment.
Erythroid burst-forming units (BFU-E) were increased in six out of 11
(54.5%) patients, and this increase preceded the rise in Hb levels in
three of them. In group B, a clonogenic assay was performed in 11 out of
16 patients before AMF treatment. In vitro results after pretreatment
with 500 M amifostine confirmed the response of two MDS patients that
achieved a PR. No response in vitro was observed in all eight
nonresponding patients and in one PR patient. The lack of response in
the clonogenic assays predicted for nonresponse to treatment with a
predictive power of 91.8%. We conclude that 300 mg/m(2) is an adequate
initial treatment for low-risk MDS patients and both clonogenic assays
have a strong predicting value for response to treatment.
Συγγραφείς:
Viniou, N
Terpos, E
Galanopoulos, A
Kritikou-Griva, E and
Akel, S
Michalis, E
Apostolidou, E
Georgiadou, D and
Kouraklis, A
Parharidou, A
Kokkini, G
Symeonidis, A and
Anagnostopoulos, NI
Christakis, JI
Tasiopoulou, A and
Loukopoulos, D
Yataganas, X
Greek MDS Study Grp
Περιοδικό:
Annals of Hematology
Λέξεις-κλειδιά:
amifostine; myelodysplastic syndrome; refractory anemia; sideroblastic
anemia; refractory anemia with excess of blasts
DOI:
10.1007/s00277-002-0442-y
