Amifostine plus erythropoietin in a patient with low-risk myelodysplastic syndrome.
Increasingly, the therapeutic use of hematopoietic growth factors and immunomodulatory agents is under investigation in patients with low-risk myelodysplastic syndrome (MDS). Studies on amifostine therapy-alone or in combination with erythropoietin (EPO)-indicate that long-term treatment is possibly a decisive factor for therapy success. Therefore, we treated an 81-year-old female, transfusion-dependent patient with MDS and refractory anemia (RA) with amifostine and EPO over a period of 2 years. Following a 4-week induction phase of 5 x 500 mg amifostine plus 3 x 10000 IU EPO per week and maintenance therapy of 1 x 500 mg amifostine plus 3 x 10000 IU EPO per week, normal hemoglobin values were reached in week 14. A long-lasting erythroid response could be observed with a reduction of EPO to 2 x 10000 IU and 1 x 10000 IU and, at present, once a week application of amifostine alone (1 x 500 mg). Apart from the 1st week, the treatment was carried out at the outpatient department and was well tolerated by the patient. The patient experienced a good general clinical condition without further need for hospitalization or blood transfusions.
Musch
E
E
Department of General Internal Medicine, Marienhospital Bottrop, Joret-Albers-Str 70, 46236 Bottrop, Germany. eugen.musch@mhb-bottrop.de
Malek
M
M
Chrissafidou
A
A
D000368:Aged; D000369:Aged, 80 and over; D004999:Amifostine / Q000627:therapeutic use*; D000740:Anemia / Q000188:drug therapy / Q000209:etiology; D018798:Anemia, Iron-Deficiency / Q000517:prevention & control; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D011837:Radiation-Protective Agents / Q000627:therapeutic use; D016896:Treatment Outcome
D011837:Radiation-Protective Agents; D004921:Erythropoietin; D004999:Amifostine