title: Menatetrenone, a vitamin K2 analog, ameliorates cytopenia in patients with refractory anemia of myelodysplastic syndrome.
abstract: Vitamin K2 induces differentiation of leukemic cell lines and apoptosis of immature blasts in myelodysplastic syndrome (MDS). We recently reported a case of MDS-refractory anemia (MDS-RA) with trilineage hematologic response to oral administration of menatetrenone, a vitamin K2 analog. To determine a possible role of this agent in treatment of MDS-RA, we conducted a prospective randomized trial assessing the safety and efficacy of menatetrenone. A total of 18 consecutive patients newly diagnosed with MDS-RA were randomized to receive either 45 mg of oral menatetrenone (group 1) or no menatetrenone (group 2). Administration of menatetrenone was well tolerated. Of the nine patients in group 1 (56%), five improved with menatetrenone treatment while only one (11%) of the group 2 patients improved. Three patients (33%) showed a major response in absolute neutrophil count (ANC), two (22%) showed a major response in hemoglobin concentration, and two of the nine (22%) showed a major response in platelet count. The ANC of group 1 patients rose after treatment, while that of group 2 patients decreased slightly at follow-up after 16 weeks ( p=0.03). Significant improvement was also seen in final platelet count ( p=0.01), but not in hemoglobin concentration. Given the absence of toxicity, menatetrenone can be recommended for all patients with MDS-RA.
authors.affiliation: Third Department of Medicine, Kanazawa University School of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan. takami@med3.m.kanazawa-u.ac.jp
authors.forename: A
authors.initials: A
authors.lastname: Takami
authors.forename: H
authors.initials: H
authors.lastname: Asakura
authors.forename: S
authors.initials: S
authors.lastname: Nakao
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000753:Anemia, Refractory / Q000188:drug therapy* / Q000473:pathology; D002452:Cell Count; D005260:Female; D006410:Hematopoiesis / Q000187:drug effects; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000473:pathology; D024482:Vitamin K 2 / Q000008:administration & dosage* / Q000031:analogs & derivatives*
chemical_list: D006490:Hemostatics; D024482:Vitamin K 2; C030814:menatetrenone