Treatment of myelodysplastic syndrome with low-dose human granulocyte colony-stimulating factor: a multicenter study
Autor: | Tanin Intragumtornchai, Suporn Chuncharunee, Wichai Prayoonwiwat, Arnuparp Lekhakula, Boonsom Chaimongkol, Yataro Yoshida, K. Chansung, Apichai Leelasiri |
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Rok vydání: | 2001 |
Předmět: |
Adult
Male medicine.medical_specialty Neutropenia Refractory anemia with ringed sideroblasts Gastroenterology Lenograstim Subcutaneous injection hemic and lymphatic diseases Internal medicine Granulocyte Colony-Stimulating Factor medicine Humans Aged Aged 80 and over Leukopenia Dose-Response Relationship Drug business.industry Hematology Middle Aged medicine.disease Recombinant Proteins Surgery Granulocyte colony-stimulating factor Hematopoiesis Myelodysplastic Syndromes Toxicity Absolute neutrophil count Female medicine.symptom business |
Zdroj: | International journal of hematology. 74(2) |
ISSN: | 0925-5710 |
Popis: | The objective of this study was to determine the hematopoietic effects and toxicity of low-dose granulocyte colony-stimulating factor (G-CSF) in myelodysplastic syndrome (MDS) patients with neutropenia. Recombinant human G-CSF (Lenograstim) was administered by daily subcutaneous injection with an initial dosage of 0.5 microg/kg per day for 2 weeks. Patients not responding to the initial dosage received the escalated dosage, 1 to 2 microg/kg per day for 2 weeks. Eligibility criteria were the following: French-American-British disease classification subtype refractory anemia (RA), refractory anemia with ringed sideroblasts (RARS), or refractory anemia with excess blasts (RAEB) with an absolute neutrophil count (ANC) of1.5 x 10(9)/L. Criteria indicating response to treatment were ANC of1.5 x 10(9)/L and doubling of ANC on at least 2 occasions. Thirty-two MDS patients were recruited from 6 university hospitals. Eighteen patients had RA, 4 had RARS, and 10 had RAEB. Median age was 56.4 years (range, 28-87 years). Twenty-six patients (81.2%) had an increase in ANC from a median of 0.94+/-0.35 x 10(9)/L to 4.24+/-3.78 x 10(9)/L. Three of 6 patients who did not respond to the initial dosage responded to the escalated dosage of 1 microg/kg per day. Eighteen (81.8%) of 22 patients with RA or RARS responded compared with 8 (80%) of 10 patients with RAEB. The response rates in patients with ANCs of0.5 x 10(9)/L. 0.5 to1.0 x 10(9)/L, and 1.0 to 1.5 x 10(9)/L were 80%, 70%, and 88.2%, respectively. The side effects were minimal. No significant changes in hemoglobin levels or platelet counts were observed. In conclusion, low-dose G-CSF administered by subcutaneous injection is well tolerated and effective in improving neutropenia in MDS patients. |
Databáze: | OpenAIRE |
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