title: Recombinant human erythropoietin for treatment of myelodysplastic syndromes.
abstract: Nine patients with myelodysplastic syndromes and one patient with agnogenic myeloid metaplasia have been treated with recombinant human erythropoietin (rhEpo), at the dose of 150 U/kg/day. Although serum Epo levels were correlated with hemoglobin concentrations in the whole population of patients, they clearly appeared inadequate in some instances, if compared to those of a group of control subjects with iron deficiency anemia. Moreover, no correlation was found between serum Epo and reticulocytes. Six patients showed a partial or complete response to the treatment and the outcome was not correlated with the pre-therapy serum Epo levels; however, serum Epo was less than 100 mU/ml in three of four patients who achieved a complete response. The mechanism(s) by which Epo stimulated erythrocyte production in myelodysplastic patients is unclear, because the number of both the reticulocytes and erythroid progenitors remained unchanged during and at the conclusion of a three months' therapy. Further studies are needed to better define the optimal dosage required to correct anemia in myelodysplastic syndromes, and to clarify rhEpo mechanism of action in these diseases.
authors.affiliation: Division of Hematology, University of Florence, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Rafanelli
authors.forename: A
authors.initials: A
authors.lastname: Grossi
authors.forename: G
authors.initials: G
authors.lastname: Longo
authors.forename: A M
authors.initials: AM
authors.lastname: Vannucchi
authors.forename: P
authors.initials: P
authors.lastname: Bacci
authors.forename: P R
authors.initials: PR
authors.lastname: Ferrini
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000473:pathology; D004906:Erythrocyte Count; D015672:Erythroid Precursor Cells / Q000473:pathology; D004921:Erythropoietin / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000473:pathology / Q000628:therapy*; D055728:Primary Myelofibrosis / Q000097:blood / Q000473:pathology / Q000628:therapy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012074:Remission Induction; D012156:Reticulocytes
chemical_list: D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin