title: Haemopoietic growth factors in myelodysplastic syndromes: towards patient-oriented therapy?
abstract: Recombinant human erythropoietin (r-EPO) has been used in Myelodysplastic Syndrome (MDS) patients with anaemia since the early nineties. In low-risk MDS patients, other haemopoietic growth factors (HGFs) (granulocyte-colony stimulating factor, G-CSF, granulocyte-macrophage-colony stimulating factor, GM-CSF, and interleukin 3, IL-3) have been used to synergise the effects of r-EPO on erythroid growth and to increase neutrophil count in patients with severe neutropenia. In high-risk MDS, or in patients with post-MDS AML, myeloid HGFs have been used to push blasts into the S-phase, thus increasing their sensitivity to antiblastic drugs. Several trials have shown that r-EPO can increase haemoglobin levels and improve QoL in patients with anaemia associated to MDS. The selection of patients with a high probability of response to HGFs is based on the careful consideration of several clinical and biological parameters, i.e., among others, basal EPO and transfusional needs, disease duration, FAB or WHO subtypes, and IPSS score. Treatment of anaemic MDS patients with HGFs should become "patient oriented" and different types, schedules, and duration of treatment have to be designed according to the specific criteria which most likely predict, for each individual patient, the best chance of responding favourably to therapy.
authors.affiliation: Dept. of Haematology and Oncology, University of Genoa, Genoa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Clavio
authors.forename: E
authors.initials: E
authors.lastname: Balleari
authors.forename: A
authors.initials: A
authors.lastname: Garrone
authors.forename: F
authors.initials: F
authors.lastname: Ballerini
authors.forename: R
authors.initials: R
authors.lastname: Varaldo
authors.forename: G L
authors.initials: GL
authors.lastname: Michelis
authors.forename: M
authors.initials: M
authors.lastname: Balocco
authors.forename: N
authors.initials: N
authors.lastname: Abdall
authors.forename: N
authors.initials: N
authors.lastname: Colombo
authors.forename: R
authors.initials: R
authors.lastname: Grasso
authors.forename: M
authors.initials: M
authors.lastname: Gobbi
mesh_terms: D000740:Anemia / Q000188:drug therapy; D016298:Hematopoietic Cell Growth Factors / Q000627:therapeutic use*; D006801:Humans; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D009503:Neutropenia / Q000188:drug therapy; D012307:Risk Factors
chemical_list: D016298:Hematopoietic Cell Growth Factors