Amifostine in combination with erythropoietin and G-CSF promotes multilineage hematopoiesis in patients with myelodysplastic syndrome.
Ineffective hematopoiesis leading to profound cytopenias represents a major clinical problem in the management of patients with myelodysplastic syndrome (MDS). The aminothiol amifostine has shown to promote multilineage hematopoiesis both in vivo and in vitro in patients with MDS. We have treated 10 patients with 250 mg/m2 amifostine thrice weekly in combination with erythropoietin for 4 consecutive weeks followed by 2 weeks observation. Responding patients received the same 6 week schedule, while nonresponder received G-CSF in addition to erythropoietin and amifostine during the second treatment course. All patients experienced single or multilineage hematologic improvement, but only 2 reached transfusion independency. Moreover, response was durable only in a minority of patients and thus additional studies are warranted to further define the potential interaction of amifostine and growth factors.
Neumeister
P
P
Department of Internal Medicine, Karl-Franzens-University Graz, Austria. peter.neumeister@gmx.at
Jaeger
G
G
Eibl
M
M
Sormann
S
S
Zinke
W
W
Linkesch
W
W
D000368:Aged; D000369:Aged, 80 and over; D004999:Amifostine / Q000008:administration & dosage / Q000494:pharmacology / Q000633:toxicity; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000494:pharmacology / Q000633:toxicity; D001772:Blood Cell Count; D019070:Cell Lineage; D004921:Erythropoietin / Q000008:administration & dosage / Q000494:pharmacology / Q000633:toxicity; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology / Q000633:toxicity; D006410:Hematopoiesis / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome
D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor; D004999:Amifostine