title: [Effect of treatment with 13-cis-retinoic acid and ara-C on the hematopoietic stem cells of patients with myelodysplastic syndromes].
abstract: OBJECTIVE
  To assess the "in vivo" effect of 13-cis-retinoic acid and low dose Ara-C in MDS as well as to establish "in vitro" advantage of retinoid dose-related growth pattern on bone marrow cultures as defined by culture timing and CFU-GM proliferative response.
  
  
  METHODS
  We evaluated 28 patients diagnosed of MDS according to FAB classification, of whom 4 cases had RA, 8 cases SRA, 14 cases RAEB and 2 cases RAEB-T. Patients who had RA and SRA were treated with oral 13-cis-retinoic acid at doses of 20-40 mg daily for 4 months and those cases with RAEB and RAEB-T had subcutaneous Ara-C at doses of 3 mg/m2 twice a day for 21 days. The "in vivo" and "in vitro" effect of retinoic acid on the haemopoietic differentiation was evaluated by the growth CFU-GM in semisolid cell culture methods.
  
  
  RESULTS
  Increasing in vitro concentrations of 13-cis retinoic acid did not enhance the growth of myelodysplastic progenitors. Nevertheless, our study did not find any beneficial therapeutic effect of retinoic compounds in MDS patients. In this study, low-dose Ara-C (3 mg/m2) showed similar effects when compared with higher doses reported by others. Furthermore, in terms of CFU-GM proliferation the concentration of colonies before and after treatment were fairly similar in all but two patients.
  
  
  CONCLUSIONS
  The results drawn from our study demonstrated that there is no beneficial advantage of 13-cis-retinoic acid as a differentiation inducing agent on myelodysplastic patients. In contrast, lower doses of Ara-C showed similar effects on haemopoiesis of MDS patients than standard doses of 10-20 mg/m2 but with less side effects.
authors.affiliation: Servicio de Hematología del Hospital General Universitari, Valencia.
authors.forename: J
authors.initials: J
authors.lastname: García Marco
authors.forename: A
authors.initials: A
authors.lastname: Miguel Sosa
authors.forename: J
authors.initials: J
authors.lastname: García Conde
authors.forename: A
authors.initials: A
authors.lastname: Miguel García
authors.forename: C
authors.initials: C
authors.lastname: Arbona
authors.forename: V
authors.initials: V
authors.lastname: Escrig
authors.forename: I
authors.initials: I
authors.lastname: Benet
authors.forename: I
authors.initials: I
authors.lastname: Navarro
authors.forename: A
authors.initials: A
authors.lastname: Ruiz
authors.forename: F
authors.initials: F
authors.lastname: Carbonell
mesh_terms: D001772:Blood Cell Count; D001853:Bone Marrow / Q000473:pathology; D002454:Cell Differentiation / Q000187:drug effects; D002478:Cells, Cultured; D003114:Colony-Forming Units Assay; D003561:Cytarabine / Q000494:pharmacology* / Q000627:therapeutic use; D006410:Hematopoiesis / Q000187:drug effects; D006412:Hematopoietic Stem Cells / Q000187:drug effects*; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D012074:Remission Induction; D014212:Tretinoin / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D003561:Cytarabine; D014212:Tretinoin
vernacular_title: Efecto del tratamiento con ácido 13 cis-retinoico y Ara-C sobre las células precursoras hematopoyéticas en pacientes con síndromes mielodisplásicos.