[The place of growth factors in the treatment of myelodysplastic syndromes].
The myelodysplastic syndromes (MDS) are clonal hematological disorders characterized by ineffective hematopoiesis manifested by anemia, neutropenia, thrombocytopenia or a combination. Correction of these cytopenia is a priority in MDS without excess of blasts. Treatment of anemia depends mainly on erythrocyte transfusions. However with the ability of recombinant human hematopoietic growth factor many trials have been promoted. In vitro, erythroid progenitors from MDS patients are able to differentiate but they require much higher concentrations of erythropoietin than normal progenitors. Trials using rHu-Epo alone are disappointing. Combining rHu-Epo and rHu-G-CSF induces more encouraging results showing a synergistic effect particularly clear in sideroblastic anemia. Patients with low endogenous Epo level and low transfusion need are more likely to respond. Clinician should be able in the future to identify MDS patients with a chance of reversal of anemia or transfusion dependency.
Ugo
Valérie
V
Service d'Hématologie Biologique, Hôtel Dieu, 1, place du parvis de Notre Dame, 75004 Paris, France.
Casadevall
Nicole
N
D000740:Anemia / Q000150:complications / Q000188:drug therapy; D004921:Erythropoietin / Q000627:therapeutic use; D013006:Growth Hormone / Q000627:therapeutic use; D006133:Growth Substances / Q000627:therapeutic use*; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000188:drug therapy*; D011994:Recombinant Proteins
D006133:Growth Substances; D011994:Recombinant Proteins; D004921:Erythropoietin; D013006:Growth Hormone