title: Progressive transfusion and growth factor independence with adjuvant sertraline in low risk myelodysplastic syndrome treated with an erythropoiesis stimulating agent and granulocyte-colony stimulating factor.
abstract: Refractoriness to growth factor therapy is commonly associated with inferior outcome in patients with low-risk myelodysplastic syndrome (LR-MDS) who require treatment for cytopenias. However, the mechanisms leading to refractoriness are unknown. Here we describe a clinically depressed 74-year-old male with refractory cytopenia with multilineage dysplasia (RCMD) and documented growth factor refractory anemia after erythropoeisis stimulating agent (ESA) therapy, who attained transfusion and growth factor independence after the addition of sertraline to his medication regimen. Our case demonstrates hematological improvement-erythroid (HI-E) in growth factor refractory, low risk MDS and highlights a potential mechanistic link between common inflammatory diseases and LR-MDS.
authors.affiliation: Department of Internal Medicine at Baylor College of Medicine, Houston, TX, USA.
authors.forename: Kirtan
authors.initials: K
authors.lastname: Nautiyal
authors.affiliation: Department of Internal Medicine at Baylor College of Medicine, Houston, TX, USA.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Internal Medicine at Baylor College of Medicine, Houston, TX, USA ; Department of Medicine, Hematology and Oncology Section, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Sarvari
authors.initials: S
authors.lastname: Yellapragada
authors.affiliation: Department of Internal Medicine at Baylor College of Medicine, Houston, TX, USA ; Department of Medicine, Hematology and Oncology Section, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Perumal
authors.initials: P
authors.lastname: Thiagarajan
authors.affiliation: Department of Internal Medicine at Baylor College of Medicine, Houston, TX, USA ; Department of Medicine, Hematology and Oncology Section, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Mims
authors.affiliation: Department of Internal Medicine at Baylor College of Medicine, Houston, TX, USA ; Department of Medicine, Hematology and Oncology Section, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rivero
keywords: Erythropoietin; Myelodysplasia; Sertraline; Transfusion dependence