Reference : Treatment of anemia in myelodysplastic syndromes with granulocyte colony-stimulating ...
Scientific journals : Article
Human health sciences : Hematology
http://hdl.handle.net/2268/8037
Treatment of anemia in myelodysplastic syndromes with granulocyte colony-stimulating factor plus erythropoietin: results from a randomized phase II study and long-term follow-up of 71 patients.
English
Hellstrom-Lindberg, E. mailto [> > > >]
Ahlgren, T. [> > > >]
Beguin, Yves mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Carlsson, M. [> > > >]
Carneskog, J. [> > > >]
Dahl, I. M. [> > > >]
Dybedal, I. [> > > >]
Grimfors, G. [> > > >]
Kanter-Lewensohn, L. [> > > >]
Linder, O. [> > > >]
Luthman, M. [> > > >]
Lofvenberg, E. [> > > >]
Nilsson-Ehle, H. [> > > >]
Samuelsson, J. [> > > >]
Tangen, J. M. [> > > >]
Winqvist, I. [> > > >]
Oberg, G. [> > > >]
Osterborg, A. mailto [> > > >]
Ost, A. [> > > >]
1998
Blood
American Society of Hematology
92
1
68-75
Yes (verified by ORBi)
International
0006-4971
1528-0020
Washington
DC
[en] Aged ; Aged, 80 and over ; Anemia/drug therapy/physiopathology ; Drug Therapy, Combination ; Erythropoietin/administration & dosage ; Female ; Follow-Up Studies ; Granulocyte Colony-Stimulating Factor/administration & dosage ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes/physiopathology ; Treatment Outcome
[en] Treatment with erythropoietin (epo) may improve the anemia of myelodysplastic syndromes (MDS) in approximately 20% of patients. Previous studies have suggested that treatment with the combination of granulocyte colony-stimulating factor (G-CSF) and epo may increase this response rate. In the present phase II study, patients with MDS and anemia were randomized to treatment with G-CSF + epo according to one of two alternatives; arm A starting with G-CSF for 4 weeks followed by the combination for 12 weeks, and arm B starting with epo for 8 weeks followed by the combination for 10 weeks. Fifty evaluable patients (10 refractory anemia [RA], 13 refractory anemia with ring sideroblasts [RARS], and 27 refractory anemia with excess blasts [RAEB]) were included in the study, three were evaluable only for epo as monotherapy and 47 for the combined treatment. The overall response rate to G-CSF + epo was 38%, which is identical to that in our previous study. The response rates for patients with RA, RARS, and RAEB were 20%, 46%, and 37%, respectively. Response rates were identical in the two treatment groups indicating that an initial treatment with G-CSF was not neccessary for a response to the combination. Nine patients in arm B showed a response to the combined treatment, but only three of these responded to epo alone. This suggests a synergistic effect in vivo by G-CSF + epo. A long-term follow-up was made on 71 evaluable patients from both the present and the preceding Scandinavian study on G-CSF + epo. Median survival was 26 months, and the overall risk of leukemic transformation during a median follow-up of 43 months was 28%. Twenty patients entered long-term maintenance treatment and showed a median duration of response of 24 months.The international prognostic scoring system (IPSS) was effective to predict survival, leukemic transformation, and to a lesser extent, duration of response, but had no impact on primary response rates.
http://hdl.handle.net/2268/8037

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