Vitamin D treatment in myelodysplastic syndromes.
Myelodysplastic syndromes (MDS) are a group of clonal disturbances with defective cellular differentiation. Vitamin D3 (VD) analogues can act on the differentiation and maturity of different cell lines. We studied the effects of VD on a series of patients with MDS in an open-design trial. Nineteen patients, 12 men and seven women, with MDS were included. Patients were 74.8 +/- 5.6 years (mean +/- SD), seven had refractory anaemia with ringed sideroblasts, five had refractory anaemia, one had refractory anaemia with excess of blasts and six had chronic myelomonocytic leukaemia. All the patients were in a low to intermediate risk group. Mean follow-up period was 26.21 months, range 9-75. Responders were defined as follows: granulocyte or platelet count increase by 50%, or haemoglobin increase of 1.5 g/dl or transfusion needs decrease by 50%. The first five patients received 266 microg of calcifediol three times a week and the other 14 received calcitriol (0.25-0.75 microg/d). Response was observed in 11 patients. In the calcifediol-treated group, one case responded, three were nonresponders, and one showed progression. In the calcitriol group, 10 were responders (two with major response), and four were non-responders. No correlation was observed between baseline levels of vitamin D metabolites and the presence of response. No hypercalcaemia was observed. Treatment with vitamin D3 metabolites could induce a long-standing response of the haematological disturbance in some low-intermediate risk MDS patients without inducing hypercalcaemia.
Mellibovsky
L
L
Department of Internal Medicine, Hospital del Mar, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
Díez
A
A
Pérez-Vila
E
E
Serrano
S
S
Nacher
M
M
Aubía
J
J
Supervía
A
A
Recker
R R
RR
D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002112:Calcifediol / Q000627:therapeutic use*; D002117:Calcitriol / Q000627:therapeutic use*; D002454:Cell Differentiation; D002455:Cell Division; D005260:Female; D005500:Follow-Up Studies; D006098:Granulocytes / Q000473:pathology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives*
D014807:Vitamin D; D002117:Calcitriol; D002112:Calcifediol