Effectiveness of recombinant human erythropoietin therapy in myelodysplastic syndromes.
In an attempt to determine predictors of response to recombinant human erythropoietin (r-HuEPO) therapy in 20 patients with various subtypes of myelodysplastic syndrome (MDS), plasma concentrations of transferrin receptor protein were measured before and after 4 doses of r-HuEPO. An r-HuEPO dosage of 150 U/kg was administered subcutaneously 3 times weekly and increased to 300 U/kg in patients who failed to raise plasma concentrations of transferrin receptor protein by at least one third. Ten (50%) patients had an effective clinical response to therapy by reducing (greater than 50%) or eliminating transfusion requirements, or by showing an improvement in haematocrit of greater than or equal to 6 percentage points. Changes in plasma transferrin receptor protein concentrations failed to predict which patients would eventually respond to r-HuEPO therapy. A subset of MDS patients demonstrated a delayed response to therapy in order to achieve a satisfactory clinical outcome. Precise predictors of response, either laboratory or clinical, remain to be determined. Continued research is warranted in this group of patients in order to specifically target r-HuEPO therapy. It is, however, likely that r-HuEPO therapy will have an effective and important role in this subset of MDS patients.
Adamson
J W
JW
New York Blood Center, N.Y.
Schuster
M
M
Allen
S
S
Haley
N R
NR
D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D001803:Blood Transfusion; D004921:Erythropoietin / Q000627:therapeutic use*; D006400:Hematocrit; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000150:complications*; D011990:Receptors, Transferrin / Q000378:metabolism; D011994:Recombinant Proteins / Q000627:therapeutic use*
D011990:Receptors, Transferrin; D011994:Recombinant Proteins; D004921:Erythropoietin