The hematologic response to anti-apoptotic cytokine therapy: results of pentoxifylline, ciprofloxacin, and dexamethasone treatment for patients with myelodysplastic syndrome.
TNF-alpha mediated apoptosis of the hematopoietic cells has been thought to contribute to the ineffective hematopoiesis observed in myelodysplastic syndrome (MDS). The combination of pentoxifylline (P) and ciprofloxacin (C) has been shown to reduce the serum levels of TNF-alpha, and an earlier trial of P and C with dexamethasone (D) provided good palliation for patients with MDS. The purpose of this study is to assess the hematologic response to PCD therapy for patients suffering with MDS. 21 of 25 patients who completed at least of 12 weeks of treatment were evaluable for the treatment efficacy. At baseline, the patient's median age was 60 yr (range: 18-75 yr). The diagnoses according to WHO classification included: RA (n=5), RCMD (n=10), RARS (n=1), RCMD/RS (n=1), RAEB (3), and CMML (n=1). 11 patients (52%) had at least single lineage response. 3 patients (11%) showed improvement of triple lineage cytopenia. There were no differences in the response rates between the FAB subtypes. The median time to response was 4 weeks (range: 2-12 weeks), and it is interesting that 9 of 11 patients who had a response remained without relapse for a median of 177 days (range: 78-634 days). These preliminary results indicate that anti-cytokine therapy with PCD is an effective and well tolerated palliative treatment for patients with MDS.
Department of Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Min Kyoung
MK
Kim
Jae Lyun
JL
Lee
Hee Soon
HS
Cho
Sung Hwa
SH
Bae
Hun Mo
HM
Ryoo
Kyung Hee
KH
Lee
Myung Soo
MS
Hyun
D000293:Adolescent; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects*; D002939:Ciprofloxacin / Q000009:adverse effects / Q000627:therapeutic use; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004906:Erythrocyte Count; D005260:Female; D006401:Hematologic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000188:drug therapy; D009325:Nausea / Q000139:chemically induced; D010431:Pentoxifylline / Q000009:adverse effects / Q000627:therapeutic use; D010976:Platelet Count; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D006401:Hematologic Agents; D014409:Tumor Necrosis Factor-alpha; D002939:Ciprofloxacin; D003907:Dexamethasone; D010431:Pentoxifylline