A Prospective Study of Cyclosporine A Treatment of Patients with Low-Risk Myelodysplastic Syndrome: Presence of CD55-CD59- Blood Cells Predicts Platelet Response
| Autor: | Yataro Yoshida, Takashi Uchiyama, Motoji T, Mitsuhiro Omine, Mineo Kurokawa, Masanao Teramura, Takayuki Ishikawa, Kaoru Tohyama, Shinji Nakao, Masaaki Takatoku, Kinuko Mitani |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Blood Platelets Male medicine.medical_specialty Adolescent Neutrophils CD59 Antigens Risk Assessment Gastroenterology Predictive Value of Tests Internal medicine Humans Medicine Prospective Studies Prospective cohort study Aged Acute leukemia Hematology CD55 Antigens Platelet Count business.industry Myelodysplastic syndromes Middle Aged Prognosis medicine.disease Ciclosporin Treatment Outcome medicine.anatomical_structure Dysplasia Myelodysplastic Syndromes Predictive value of tests Immunology Cyclosporine Erythrocyte Count Female Bone marrow business Immunosuppressive Agents medicine.drug |
| Zdroj: | International Journal of Hematology. 86:150-157 |
| ISSN: | 0925-5710 |
| DOI: | 10.1532/ijh97.07052 |
| Popis: | Although immunosuppressive therapy using antithymocyte globulin or cyclosporine A (CSA) is effective in selected patients with low-risk myelodysplastic syndrome, the response rates reported so far are inconsistent, and the indication of immunosuppressive therapy for myelodysplastic syndrome has not been clearly defined. We treated 20 myelodysplastic syndrome patients (17 refractory anemia cases [RA], 2 RA with excess blasts, and one RA with ringed sideroblasts) with 4 mg/kg per day of CSA for 24 weeks. Among the 19 patients evaluated, 10 showed hematologic improvement; 8 patients showed an erythroid response, 6 showed a platelet response, and one showed a neutrophil response. Most patients with hematologic improvement continued CSA thereafter, and the progressive response was observed until the latest follow-up (median, 30 months). Most toxicities associated with CSA usage were manageable, and no patient had developed acute leukemia up to this point. Short duration of illness, refractory anemia with minimal dysplasia determined by bone marrow morphology, and the presence of paroxysmal nocturnal hemoglobinuria-type cells were significantly associated with the platelet response. A minority of RA patients who did not possess such predictive variables achieved an isolated erythroid response. In conclusion, CSA may be a therapeutic option for patients with RA who do not have adverse prognostic factors. |
| Databáze: | OpenAIRE |
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