Cytokine therapy for myelodysplastic syndrome.
The myelodysplastic syndromes are a heterogeneous family of hematologic disorders characterized by ineffective hematopoiesis. Because of the interpatient variability regarding prognosis and morbidity, management of myelodysplastic syndromes continues to be a challenge to clinical hematologists. Pancytopenia and defective function of neutrophils and platelets carry a high risk of infectious or hemorrhagic complications. Erythropoietin is perhaps the most commonly used therapeutic option, second only to transfusion; improvement of erythropoiesis is seen in approximately 20% of patients, mainly in those with relatively preserved erythroid function and no or low transfusion requirements. Coadministration of erythropoietin with either granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor may increase the response rate up to 50%. Although prophylactic administration of granulocyte- or granulocyte-macrophage colony-stimulating factor cannot be recommended, treatment of febrile neutropenia might benefit from administration of granulocyte- or granulocyte-macrophage colony-stimulating factor in addition to antibiotics.
Seipelt
G
G
Department of Hematology/Oncology, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany.
Ottmann
O G
OG
Hoelzer
D
D
D017209:Apoptosis / Q000187:drug effects; D016207:Cytokines / Q000097:blood / Q000627:therapeutic use*; D004921:Erythropoietin / Q000097:blood / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D010198:Pancytopenia / Q000188:drug therapy / Q000517:prevention & control; D012307:Risk Factors
D016207:Cytokines; D004921:Erythropoietin