Recombinant human erythropoietin for the treatment of anaemia in the myelodysplastic syndromes

Second

International

Conference

Thus study

was

performed

recombinant

to examine

human U/kg).

weeks

at each

in 10 patients

and

concomitant

red blood

had

of these

patients

had

normalized

with

a decline

survival

eventually to 12.3 g/dl.

the

increased

not increase

A transient

respectively.

I” blast

was

transient patients poiesis

seen

elevation with

low

of serum

as measured

for treatment

with

the fraction

These

of IIT in the

EPO levels

and

human

with

relatively

studies

iron The

may

patients.

accompanied The

patients.

in the

spared be the

noticed increase

showed

anaemic effective best

Red

responding was

patient that

other

EPO treatment.

a sustained

suggest

of

but 3 of

patients.

count

another

and

in serum

(IIT). later

even

in platelet

while

results

by ferrokinetic

recombinant

was

RCIT before

progression

patient.

in three

turnover

EPO therapy, increase

Disease I” one

mu/ml).

in RCIT

iron

preserved

during

blasts,

cell

an

levels

in 2 responding

increase

red

or maintained

in 2 patients. cells

This

had a relatively

further did

patient. ineffective

serum

A decrease

increased

for

with

pyruvatekinase.

independent.

(1 W-5703

level.

for 4

syndromes

requirements

and

responses to treetment (KIT)

escalating

accompanied

Endogenous

in all patients

turnover

in one in

The

transfusion

low base-line

at

per week

myelodysplastic

patients.

AF-

subcutaneous

times

hexokinase

became

of

(rhEP0)

anaemia. in four

7.7 g/d1

reflected iron

effects three

with

enzymes

increased

patients

EPO therapy

cell

a relatively

red cell

even

patients.

from

levels

responding

improved

blood

significant

ferritin

effective

cell

red

a rise of lib

4 responders

administered

transfusion-dependent

in the

EPO were and

level.

cell transfusion

increase One

dose

the

erythropoietin

(1GO. 300. and,S4Nl

PATIENTS SYNDROME

~~“&$&.~!-~$+IB;fi~D~ a ;!?$ $I&ELLIF.” ” V” Clinica Medica,,’ Cattedra di Ematol ‘a - Univcrsit& di Roma “La Sapienza”, Direzione Medica - CI?!5 G - S.pA.

G. Verhoef, P. Zachee. A Ferrant. H Demuynck, 0. Selleslag, and M. Boogaerts. Department of Haematology, University Hospitals Gasthuisberg and St-Luc. Leuven and Brussels. Belgium.

doses

33

Syndromes

OF rHuEP0 ADMINZSTRATION IN TESTS FECTED BY MIELODISPLASTIC ENDOCRIN~METABOLIC FiVALUATION

RECOMBINANT HUMAN ERYTHROPOlETlN FOR THE TREATMENT OF ANAEMIA IN THE MYELODYSPLASTIC SYNDROMES.

administered

on Myelodysplastic

a

MDS eryihro-

candidates

EPO preparations.

TRLllnlENlOF nYELaSYSPLaSlIc SYllDRmES (IISSI YITH REcmlBIRfW HWl ERYWtSPOIRIW WfeEm): PRELIlIWY CLIllcly RLsuTs. Petti K, hloe-Spiriti NR, Lataglirtr R, Bertelletti Ct, Jaalodk 6, De Felice L, Valentini 1, Vi!!a Rt, landelli F. Haeoatology, lluran Biopathologr Dept., University ‘La Sapier,ia’ of Rare t CILAO Spa, Nedical Direction Riluo. Erythropoietin is a well-established treateen! for aneeia related to chronic renal failure: hwevei i beneficial effect could be achieved by increasing sndqenous EPO titers in other aoerias. ile used !~igh doses of rHuEP0 ia NDS patients rith anria and/w transfaional need. Free April’90 to Harch’91 lb patients ( 9 RR, 3 SA, 5 RIXB) were treated with rHuEP0 400 U/Kg 2 tires weekly for 3 rgnths. Median age was 58,s years and aedian period froe the diagnosis was 18 eonths. 1X16 patients had tranfusimal reguirerent 12-1 packed red cells eonthly), 3116 were transfusion independent with Hb ( 9 gldl. If a coeplete respcnse (norealization of Hb levels) was achieved, the saee dose aas given for additional 3 eaeths;if a partial response ( stable increase of Hb levels ) 1 gZ and/or reductioe of transfusional need ) SOL) uas achieved, an increased daee of 600 U/Kg uas given for the saee period. If no response nas Observed, the treateent nas stopped. 111 patimts are evaluable fur response. No coqlete response nas observed uhile 5/16 patimts achieved a partiai response (2 becoee transfusion-free free 7 aed 9 eonths respectively, 1 shwed a decrease ) 501 in transfurioeal need and 2 increased H levels ) 1 9Z); 9116 patients were resistant. Reticulocyte cwnt shoeed a significant increase in 2/5 partial respondersi PIllI ceuet increased in other 2 responder patients. lb changes in the others peripheral and bone earrow paraeeters was evidmcied. The treatmt was rell-tolerated without adverse reactions. Our prelieinar results suggest that a little rate of RDS patients can achieve so#e benefit free EPS treatrent.

DESFJZRRIOXAMINE TREATMENT REDUCES BLOOD TRANSFUSION REQUIREMENTS IN PATIENTS WITH MYELODYSPLASTIC SYNDROME Jensen, P-D., Jensen, University Department

LM., Ellegaard. J. of Medicine and Haematology,

AArhus Amtssygehus, Tage Hansens Gade, DK-8000 AArhus. Six multitransfused patients, with myelodysplastic syndrome (MDS), were treated for transfusional iron overload (given from 59 to 264 units of red cells). The influence of desferrioxamine treatment on mean Hb-requirement, mean of PLC, WBC and RBC-volume was investigated retrospectively. In all patients Hbrequirements (mmoi Hb./monrh) decreased during treatment. in 3 patients significantly. The reduction of Hb-requirement was 30% to 46% in patients treated continuously by infusion pump

and 1.7% to 12% in patients treated by bolus injections. In 3 patients the mean PLC increased significantly, and in 2 of them the mean granulocyte count 6 patient the RBC-volume changes in RBCHC.

also increased significantly

significantly. decreased

In 5 of without

The changes in RBC-volume arc imcrpreted as normalizing erythropoiesis. and the increase of PLC and WBC, as well as the decreased Hb-requirement could indicate a beneficial effect of desferrioxamine on all three cell lineages in the bone marrow, in MDS patients.