[Clinical application of retinoic acid and vitamin D3 derivatives to the treatment of refractory anemias].
Refractory anemias and the myelodysplastic syndromes are a group of hematopoietic stem cell disorders characterized by ineffective and dysplastic hematopoiesis, leading to persistent peripheral cytopenias. Patients also have an increased risk of transformation to acute myelogenous leukemia. Since defective cellular maturation is the central pathogenetic feature, improved differentiation may result in correction of neutropenia and thrombocytopenia. Clinical trials using retinoic acid and vitamin D3 analogues are not satisfactory and only small numbers of patients may benefit from receiving them. In view of the absence of other effective treatment, future studies should be directed to the combined use of differentiating agents with hematopoietic growth factors and to the identification of new compounds with greater differentiating ability and less toxicity.
Department of Medicine, Faculty of Medicine, Kyoto University.
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Yoshida
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000753:Anemia, Refractory / Q000188:drug therapy*; D000818:Animals; D002762:Cholecalciferol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy; D014212:Tretinoin / Q000627:therapeutic use*
D002762:Cholecalciferol; D014212:Tretinoin