Hematologic responses of patients with MDS to antithymocyte globulin plus etanercept correlate with improved flow scores of marrow cells.

Abstract

Myelodysplastic syndrome (MDS) comprises a spectrum of heterogeneous diseases. Most patients present with ineffective hematopoiesis. The pathophysiology involves immune-mediated effects, cytokine dysregulation, and apoptosis, among others. We treated 14 transfusion-requiring patients with MDS, 10 with refractory anemia (RA) and four with RA with excess blasts (RAEB) with a 4-day course of antithymocyte globulin (ATG) followed by intermittent etanercept for 4 months. Among 13 evaluable patients, five are red blood cell and platelet transfusion independent for intervals extending beyond 2 years, and two have normalized their peripheral blood parameters. One additional patient showed a transient rise of platelet and neutrophil counts, for an overall response rate of 46%. Responding patients showed striking improvements in marrow cell abnormalities as characterized by flow cytometry. These data show that a combination of ATG plus etanercept offers effective palliative therapy for unselected patients with MDS. Further trials incorporating these two agents are warranted.

• Authors: H Joachim Deeg, Peter Y Z Jiang, Leona A Holmberg, Bart Scott, Effie W Petersdorf, Frederick R Appelbaum
• Journal: Leukemia research (Leuk Res) Vol. 28 Issue 11 Pg. 1177-80 (Nov 2004) ISSN: 0145-2126 [Print] England
• PMID: 15380342 (Publication Type: Clinical Trial, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antilymphocyte Serum
• Immunoglobulin G
• Receptors, Tumor Necrosis Factor
• Etanercept

Topics

• Antilymphocyte Serum (therapeutic use)
• Etanercept
• Humans
• Immunoglobulin G (therapeutic use)
• Myelodysplastic Syndromes (drug therapy, pathology, therapy)
• Pilot Projects
• Receptors, Tumor Necrosis Factor (therapeutic use)