title: Long-term erythropoietin therapy improves response in myelodysplastic syndrome.
abstract: We report on a 53-year-old Japanese female on hemodialysis with myelodysplastic syndrome whose condition improved with recombinant human erythropoietin (epoetin) therapy. In 1992, based on a diagnosis of folic acid deficiency anemia, folate derivatives were administered. However, the anemia did not improve, and red blood cells had to be transfused subsequently. The transfusion volume was gradually increased afterward, as renal failure progressed, probably due to nephropathy by phenacetin. In 1998, when hemodialysis started, epoetin therapy was started with a dose of 3000 units three times per week. In July 2001, myelodysplastic syndrome (MDS) of a refractory anemia type was diagnosed through bone marrow aspiration. Myelodysplastic syndrome might cause an epoetin-resistant renal anemia. Afterwards the transfusion volume was gradually reduced, and transfusions were not performed after March 2002. Improvements of histological findings of MDS as well as anemia were confirmed by bone marrow aspiration in July 2003. This is an unusual case of a patient with a previously existing MDS, who subsequently develops end stage renal disease, and has an amelioration of her underlying MDS with the administration of epoetin over a long-term period, while being treated with chronic hemodialysis, even when not effective for a short-term.
authors.affiliation: Toranomon Hospital, Tokyo, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Ohshima
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ubara
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Tagami
authors.forename: Naoki
authors.initials: N
authors.lastname: Sawa
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suwabe
authors.forename: Kenjirou
authors.initials: K
authors.lastname: Yamakawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Hoshino
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Katori
authors.forename: Fumi
authors.initials: F
authors.lastname: Takemoto
authors.forename: Shigeko
authors.initials: S
authors.lastname: Hara
authors.forename: Jyusaburou
authors.initials: J
authors.lastname: Miyakoshi
authors.forename: Kenmei
authors.initials: K
authors.lastname: Takaichi
mesh_terms: D004921:Erythropoietin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000628:therapy; D011994:Recombinant Proteins; D006435:Renal Dialysis
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin