Document Detail


Treatment of anaemia in myelodysplastic syndromes with prolonged administration of recombinant human granulocyte colony-stimulating factor and erythropoietin.
MedLine Citation:
PMID:  10848827     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment with recombinant human erythropoietin (rhEPO) improves anaemia in approximately 20% of the patients with myelodysplastic syndromes (MDS). Recent reports suggest that a combination treatment with rhEPO plus recombinant human granulocyte colony-stimulating factor (rhG-CSF) given for up to 18 weeks may result in a higher erythroid response rate than with rhEPO alone. We investigated the potential advantage of an even more prolonged schedule of combined rhG-CSF and rhEPO treatment to obtain and maintain stable responses. In a phase II study, 33 patients with MDS [17 with refractory anaemia (RA), eight with RA with ringed sideroblasts (RARS), eight with RA with excess blasts (RAEB) with bone marrow blast counts less than 20%] were scheduled to receive at least 36 weeks of combined therapy with rhG-CSF and rhEPO. Seventeen of 28 evaluable patients demonstrated an erythroid response [61%; 95% confidence interval (CI) 41-78] after 12 weeks of treatment. The erythroid response rate was 80% (20 of 25 evaluable patients; 95% CI 59-93) after 36 weeks. Seven of these responses developed between week 12 and week 36, whereas two initially responding patients became refractory. The cytokine therapy was generally well tolerated. Nineteen of the 20 patients responding after 36 weeks continued to be treated with both cytokines. After 1 year and 2 years of continuous combined treatment, 50% of the initially included patients showed a continuing response. Our results suggest that a prolonged combination treatment with rhG-CSF and rhEPO is highly effective in achieving a stable and long-lasting erythroid response in many patients with MDS and low blast count.
Authors:
L Mantovani; G Lentini; B Hentschel; P D Wickramanayake; M Loeffler; V Diehl; H Tesch
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase II; Journal Article    
Journal Detail:
Title:  British journal of haematology     Volume:  109     ISSN:  0007-1048     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-06-26     Completed Date:  2000-06-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  367-75     Citation Subset:  IM    
Affiliation:
Department of Haematology and Oncology, St Georg Hospital, Leipzig, Germany. mantovani@imise.uni-leipzig.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anemia / blood,  drug therapy*
Disease-Free Survival
Drug Administration Schedule
Drug Therapy, Combination
Erythrocyte Count
Erythropoietin, Recombinant / administration & dosage*,  therapeutic use
Female
Granulocyte Colony Stimulating Factor, Recombinant / administration & dosage*,  therapeutic use
Humans
Male
Middle Aged
Myelodysplastic Syndromes / blood,  drug therapy*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Erythropoietin, Recombinant; 0/Granulocyte Colony Stimulating Factor, Recombinant

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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