Cyclosporin A therapy for patients with myelodysplastic syndrome: multicenter pilot studies in Japan.
We examined the efficacy of cyclosporin A (CsA) in 50 patients with myelodysplastic syndrome (MDS) consisting from 47 of RA, 1 of RARS, and 2 of RAEB. These patients showed various marrow cell types including hypo-, normo-, and hypercellularity. Patients belonged to the following International Prognostic Scoring System (IPSS) risk groups: 4 of low, 41 of intermediate-1, and 5 of intermediate-2. The median CsA dose was 4.58mg/kg, and treatment responses were classified according to the International Working Group (IWG) criteria. Hematological improvement (HI) was observed in 30 (60%) patients, and all of them were belonged to RA. In the patients with RARS or RAEB, no efficacy was observed. Four (8%) of the responders achieved partial remission (PR) with granulocytes > or = 1500microl(-1), Hb>11g/dl and platelets > or = 100,000microl(-1). Higher response rate (53%) was shown in erythroid lineage (HI-E) compared to platelet (HI-P, 36%) or neutrophil lineage (HI-N, 35%). When we analyzed the correlation between the response to CsA therapy and the karyotype or HLA type, there were significantly more responders with good karyotype or DRB1*1501 than with intermediate/poor karyotypes or with other HLA types. These results indicate the usefulness of CsA therapy for MDS patients with any marrow cellularity, especially for erythroid lineage and patients with good karyotype or DRB1*1501.
Shimamoto
Takashi
T
First Department of Internal Medicine, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. shimamtt@tokyo-med.ac.jp
Tohyama
Kaoru
K
Okamoto
Takahiro
T
Uchiyama
Takashi
T
Mori
Hiroyuki
H
Tomonaga
Masao
M
Asano
Yoshinobu
Y
Niho
Yoshiyuki
Y
Teramura
Masanao
M
Mizoguchi
Hideaki
H
Omine
Mitsuhiro
M
Ohyashiki
Kazuma
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000753:Anemia, Refractory / Q000097:blood / Q000188:drug therapy; D000754:Anemia, Refractory, with Excess of Blasts / Q000097:blood / Q000188:drug therapy; D001792:Blood Platelets / Q000737:chemistry; D001853:Bone Marrow / Q000473:pathology; D019070:Cell Lineage; D016572:Cyclosporine / Q000627:therapeutic use*; D004341:Drug Evaluation; D004912:Erythrocytes / Q000737:chemistry; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007564:Japan; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000188:drug therapy*; D009504:Neutrophils / Q000737:chemistry; D010865:Pilot Projects; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016572:Cyclosporine