Therapeutic effect of heme arginate in myelodysplastic syndromes.

In order to investigate, whether heme would induce a response in myelodysplastic syndromes (MDS), 14 symptomatic patients (4 RA, 3 RARS and 7 RAEB) were treated with infusions of heme arginate 3 mg/kg body weight on 4 consecutive days, mostly for six cycles at 2-week intervals. Three of 14 patients (21%) showed an improvement in anemia (97-152, 79-120 and 92-114 g/l) within a few weeks, and 1 showed a milder increase in hemoglobin level (102-118 g/l). Of the 2 responders with marked thrombocytopenia, 1 showed an improvement in the platelet count (7-37 x 10(9)/l) and her regular need for red cell and platelet transfusions ceased. Some regression in bone marrow (BM) cytology was seen in all 3 responders. One of the responders is still in remission 41 months after cessation of the treatment, while in the other 2 the response lasted for 26 and 5 months. Four patients progressed during the treatment: 1 RA to RAEB, 1 RAEB to RAEBt and 2 RAEB, both with very complex chromosomal abnormalities at the beginning of the therapy, to acute erythroleukemia (AML-M6). Pretreatment delta-aminolevulinic acid synthase and heme synthase activities were generally low. Five patients had mild thrombophlebitis, but not after the infusion procedure was changed. No other side-effects common to growth factors occurred. In conclusion, it is likely that heme arginate has a therapeutic effect on some MDS patients, obviously by stimulating erythropoiesis. The response may be long-lasting.
AuthorsT T Timonen, H Kauma
JournalEuropean journal of haematology (Eur J Haematol) Vol. 49 Issue 5 Pg. 234-8 (Nov 1992) ISSN: 0902-4441 [Print] DENMARK
PMID1473585 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Erythropoietin
  • Heme
  • Arginine
  • Creatinine
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • heme arginate
  • Adult
  • Aged
  • Alanine Transaminase (blood)
  • Arginine (adverse effects, therapeutic use)
  • Aspartate Aminotransferases (blood)
  • Bone Marrow (pathology)
  • Creatinine (blood)
  • Erythropoietin (blood)
  • Female
  • Heme (adverse effects, therapeutic use)
  • Humans
  • Karyotyping
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes (blood, drug therapy, pathology)

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