Low-dose etoposide: a potential therapy for myelodysplastic syndromes.
Four patients with refractory anaemia with excess blasts in transformation (RAEB-t) and seven patients with acute leukaemia (AL) transformed from myelodysplastic syndromes (MDS) were treated with etoposide (50 mg, 2 h infusion, two to seven times per week) for at least 4 weeks. Of 10 assessable patients, three RAEB-t patients achieved partial response and one AL patient achieved complete remission. Three of the four responders were resistant to prior repeated low-dose cytarabine therapy. The responders did not require transfusions for 2-9 months while continuing on etoposide therapy. The side-effects were mild and well tolerated. Three possible mechanisms, i.e. a cytotoxic effect, differentiation-induction of malignant cells, and prolongation of blood cell survival by destroying the reticuloendothelial system, may explain the effects of etoposide. We conclude that low-dose etoposide is a potential therapy for MDS and atypical leukaemia.
Ogata
K
K
Third Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Yamada
T
T
Ito
T
T
Gomi
S
S
Tanabe
Y
Y
Ohki
I
I
Dan
K
K
Nomura
T
T
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000754:Anemia, Refractory, with Excess of Blasts / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D001853:Bone Marrow / Q000473:pathology; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*
D005047:Etoposide