Ask the Experts - Epoetin in Myelodysplastic Syndrome
Ask the Experts - Epoetin in Myelodysplastic Syndrome
What are the benefits of the use of epoetin in myelodysplastic syndrome (MDS)? Can I have the latest recommendations concerning this issue?
MDSs are characterized initially by ineffective hematopoiesis and, subsequently, by the frequent development of acute myelogenous leukemias (AMLs). Allogeneic stem cell transplantation is still the only curative treatment that prolongs survival, although supportive therapy remains the mainstay in the management of patients with MDS. Desferrioxamine should be administered to individuals who have a regular need for blood transfusion. Hematopoietic growth factors can be useful in the treatment of selected patients with MDS and, currently, recombinant human erythropoietin (rhuEpo) and granulocyte colony-stimulating factor (G-CSF) are the agents with most clinical data.
Overall, 15% to 20% of patients with MDS respond to rhuEpo treatment. Factors predicting response include serum erythropoietin levels less than 100 mU/mL to 200 mU/mL, low-risk MDS, and no or low need for transfusion. The doses required to achieve response are greater than 450 IU/kg per week.
American and Scandinavian studies have shown that about 40% of patients with MDS respond to a combined treatment of rhuEpo with G-CSF with amelioration of anemia. The response can be maintained for a median duration of 24 months. Currently, therapy of MDS remains palliative in most instances, and active research is encouraged.
What are the benefits of the use of epoetin in myelodysplastic syndrome (MDS)? Can I have the latest recommendations concerning this issue?
MDSs are characterized initially by ineffective hematopoiesis and, subsequently, by the frequent development of acute myelogenous leukemias (AMLs). Allogeneic stem cell transplantation is still the only curative treatment that prolongs survival, although supportive therapy remains the mainstay in the management of patients with MDS. Desferrioxamine should be administered to individuals who have a regular need for blood transfusion. Hematopoietic growth factors can be useful in the treatment of selected patients with MDS and, currently, recombinant human erythropoietin (rhuEpo) and granulocyte colony-stimulating factor (G-CSF) are the agents with most clinical data.
Overall, 15% to 20% of patients with MDS respond to rhuEpo treatment. Factors predicting response include serum erythropoietin levels less than 100 mU/mL to 200 mU/mL, low-risk MDS, and no or low need for transfusion. The doses required to achieve response are greater than 450 IU/kg per week.
American and Scandinavian studies have shown that about 40% of patients with MDS respond to a combined treatment of rhuEpo with G-CSF with amelioration of anemia. The response can be maintained for a median duration of 24 months. Currently, therapy of MDS remains palliative in most instances, and active research is encouraged.
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