title: Cyclosporin A in myelodysplastic syndrome: a preliminary report.
abstract: Therapeutic approaches are not well established in patients with myelodysplastic syndrome (MDS). We evaluated response to cyclosporin A (CyA) in 19 cases with MDS who were enrolled for the study [13 refractory anemia (RA), 5 refractory anemia with excess of blasts (RAEB), and 1 refractory anemia with ringed sideroblasts (RARS)]. Bone marrow was normocellular in ten, hypercellular in five, and hypocellular in four cases. Fifteen patients were transfusion dependent and the rest were not transfusion dependent but with a hemoglobin range of 6.4-8.8 g% with a mean of 7.4 g%. CyA was given at a dose of 3-5 mg/kg per day. A major response was observed in seven patients with RA, which was sustained on follow-up. Four cases of RA showed minor response and two cases of RA did not respond to CyA therapy. A minor response was also seen in one RAEB and one RARS case, while one RAEB case that initially showed a major response relapsed on therapy. The first effect of therapy was evident after a mean period of 2.5 months. A rise in platelets and leukocyte count was seen in three and two cases, respectively. One case developed renal failure on therapy and later died of septicemia. Response to CyA was independent of bone marrow cellularity. CyA could be an effective mode of therapy in patients with MDS especially those having RA.
authors.affiliation: Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Dixit
authors.forename: Tathagat
authors.initials: T
authors.lastname: Chatterjee
authors.forename: Pravas
authors.initials: P
authors.lastname: Mishra
authors.forename: Dharma R
authors.initials: DR
authors.lastname: Choudhary
authors.forename: Manoranjan
authors.initials: M
authors.lastname: Mahapatra
authors.forename: Renu
authors.initials: R
authors.lastname: Saxena
authors.forename: V P
authors.initials: VP
authors.lastname: Choudhry
mesh_terms: D000328:Adult; D000368:Aged; D000753:Anemia, Refractory / Q000188:drug therapy; D000754:Anemia, Refractory, with Excess of Blasts / Q000188:drug therapy; D000756:Anemia, Sideroblastic / Q000188:drug therapy; D001853:Bone Marrow / Q000473:pathology; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D010976:Platelet Count; D051437:Renal Insufficiency / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D016572:Cyclosporine