Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study

Autor: Hong Lin, Emily Vertosick, Stephen D. Nimer, Barrie R. Cassileth, Marci Coleton, Susanna Cunningham-Rundles, Kathleen M. Wesa, K. Simon Yeung, Virginia M. Klimek
Rok vydání: 2014
Předmět:
Male
Ineffective erythropoiesis
Cancer Research
Neutrophils
Maitake
Beta-glucan
Monocyte
medicine.disease_cause
Monocytes
0302 clinical medicine
Bone Marrow
hemic and lymphatic diseases
Immunology and Allergy
0303 health sciences
Neutrophil
Middle Aged
3. Good health
Leukemia
Treatment Outcome
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Female
Original Article
Karyotype
Immunology
Antineoplastic Agents
Bone Marrow Cells
Complex Mixtures
Biology
Infections
Hematopoietic progenitor cell differentiation
03 medical and health sciences
Myelogenous
medicine
Humans
Maitake Mushroom Extract
Aged
030304 developmental biology
Cytopenia
Myelodysplastic syndromes
medicine.disease
Case-Control Studies
Myelodysplastic Syndromes
Bone marrow
Reactive Oxygen Species
Myelodysplastic syndrome
Biomarkers
Grifola
Zdroj: Cancer Immunology, Immunotherapy
ISSN: 1432-0851
0340-7004
DOI: 10.1007/s00262-014-1628-6
Popis: Background Myelodysplastic syndromes (MDS) are characterized by ineffective erythropoiesis with dysplastic bone marrow leading to peripheral cytopenia, risk of infection, and progression to acute myelogenous leukemia. Maitake mushroom beta-glucan, a dietary supplement, stimulates hematopoietic progenitor cell differentiation, granulocyte colony-stimulating factor production, and recovery of peripheral blood leukocytes after bone marrow injury. This phase II trial examined the effects of Maitake on innate immune function in MDS. Methods Myelodysplastic syndromes patients with International Prognostic Scoring System Low- and Intermediate-1-risk disease received oral Maitake extract at 3 mg/kg twice daily for 12 weeks. Primary endpoints included neutrophil count and function tested as endogenous or stimulated neutrophil production of reactive oxygen species (ROS) by flow cytometry compared with age-matched healthy controls (HC). ROS activators were Escherichiacoli, phorbol ester, and the bacterial peptide N-formylmethionyl-leucyl-phenylalanine (fMLP). Complete blood counts, chemistry panels, iron studies, and monocyte function were evaluated. Results Of 21 patients enrolled, 18 completed the study and were evaluable. Maitake increased endogenous (basal) neutrophil (p = 0.005) and monocyte function (p = 0.021). Pre-treatment monocyte response to E. coli was reduced in MDS patients compared with HC (p = 0.002) and increased (p = 0.0004) after treatment. fMLP-stimulated ROS production response also increased (p = 0.03). Asymptomatic eosinophilia occurred in 4 patients (p = 0.014). Other changes in albumin, hemoglobin, and total protein were not clinically relevant. Conclusions Maitake was well tolerated. Enhanced in vitro neutrophil and monocyte function following treatment demonstrate that Maitake has beneficial immunomodulatory potential in MDS. Further study is warranted.
Databáze: OpenAIRE
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