title: Treatment of myelodysplastic syndromes with recombinant human erythropoietin.
abstract: 12 patients with myelodysplastic syndromes were treated with recombinant human erythropoietin (r-epo). 5 patients had stable anemia, 78-92 g/l, and 7 were transfusion-dependent. In 11 patients, r-epo was given intravenously three times a week, with dose escalation after 4 and 8 wk if hemoglobin did not increase more than 15 g/l. The doses were 600, 1500 and 3000 U/kg bodyweight/wk. The 12th patient was treated subcutaneously with a dose of 560 U/kg/wk. 3 patients showed a significant response with an increase in hemoglobin of greater than or equal to 15 g/l. 2 of these had stable anemia before treatment and increased in hemoglobin from 87 to 116 g/l and from 80 to 99 g/l, respectively. The 3rd patient was transfusion-dependent and rose to a stable hemoglobin level between 76 and 80 g/l without transfusions. 2 patients showed a reduction of their transfusion need. Mean initial serum erythropoietin in the responding group was 366 U/l compared to 1049 among the non-responders (p = 0.367). Response was observed in 5/7 patients without bone marrow sideroblasts and in 0/5 patients with sideroblasts (p = 0.027). Erythropoietin seems to be an effective and well-tolerated treatment for a certain proportion of patients with MDS. A larger patient material might provide a model for predicting responses.
authors.affiliation: Department of Medicine, Huddinge Hospital, Stockholm, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Hellström
authors.forename: G
authors.initials: G
authors.lastname: Birgegård
authors.forename: D
authors.initials: D
authors.lastname: Lockner
authors.forename: C
authors.initials: C
authors.lastname: Helmers
authors.forename: A
authors.initials: A
authors.lastname: Ost
authors.forename: L
authors.initials: L
authors.lastname: Wide
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000209:etiology
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin