Changes in hemopoietic precursors after treatment of low-risk myelodysplasia with amifostine.
BACKGROUND
Clinical studies have shown that amifostine (AMF) improves peripheral cytopenias in myelodysplastic syndromes (MDS). We studied the expression of Fas/FasL on CD34+ cells in low risk MDS and its change after AMF treatment.


METHODS
Patients received AMF 400 mg/m2 3x/week for 3 weeks and 2 weeks off treatment. Peripheral blood counts and BM cytology were analysed before and after 2 courses. Quantification of CD34+ cells and CD34/CD95 and CD34/CD95L ones were performed by flow cytometry.


RESULTS
Seventeen patients were treated. After 2 months, 8 patients showed a rise in neutrophil count. Hemoglobin increased in 1 and thrombocytes in 2 patients. Before treatment, responding patients presented a significantly lower expression of Fas (median 53%) and FasL (median 26%) than non-responders (85% and 70%, respectively). BM lymphocytes were significantly lower in responders (median 14.5% and 27.4%, respectively). In responders CD34+ cells decreased after treatment. The change in neutrophil count after treatment presented an inverse correlation with the percentage of BM lymphocytes before treatment (r = 0.0-0.58; p = 0.02).


CONCLUSIONS
Response to AMF may be influenced by the intensity of the immune reaction in BM.
Ribeiro
Elisangela
E
Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Brazil.
Lima
Carmen S P
CS
Metze
Konradin
K
Souza
Carmino A
CA
Lorand-Metze
Irene
I
D000328:Adult; D000368:Aged; D004999:Amifostine / Q000627:therapeutic use*; D018952:Antigens, CD34 / Q000378:metabolism; D001772:Blood Cell Count; D001853:Bone Marrow / Q000187:drug effects; D053222:Fas Ligand Protein; D005260:Female; D005434:Flow Cytometry; D006410:Hematopoiesis / Q000187:drug effects* / Q000502:physiology; D006412:Hematopoietic Stem Cells / Q000187:drug effects* / Q000378:metabolism; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000188:drug therapy*; D009504:Neutrophils / Q000187:drug effects; D011837:Radiation-Protective Agents / Q000627:therapeutic use*; D019014:fas Receptor / Q000378:metabolism
D018952:Antigens, CD34; C505661:FASLG protein, human; D053222:Fas Ligand Protein; D006454:Hemoglobins; D008562:Membrane Glycoproteins; D011837:Radiation-Protective Agents; D019014:fas Receptor; D004999:Amifostine