Abstract |
The purpose of this study was to determine the efficacy of and tolerance to antithymocyte globulin (ATG)-based therapy in patients with myelodysplastic syndrome (MDS). Therapy consisted of ATG 40 mg/kg/day daily intravenously (i.v.) for 4 days; cyclosporine daily orally for 6 months with levels titrated between 200 and 400 mg/dl; and methylprednisone 1 mg/kg i.v. daily before each dose of ATG. Of 32 patients treated, 31 patients were evaluable. The median age was 59 years (range, 28-79 years). A total of 18 patients had refractory anemia (RA) or RA with ringed sideroblasts (RARS), 10 patients had RA with excess blasts ( RAEB), two patients had RAEB in transformation, and one patient had chronic myelomonocytic leukemia. ATG, cyclosporine, and methylprednisone induced complete (N=4) or partial (N=1) remission in five patients (16% of total; RA, two patients; RARS, two patients; and RAEB, one patient). Durable complete remissions were observed in three of 18 patients (17%) with RA (N=1) or RARS (N=2) (12, 41+, and 60+ months). The most common adverse events were fever and allergic reactions. Hepatic and renal dysfunction, albeit consistently reversible, occurred in 19 and 13% of the patients, respectively. In conclusion, an ATG-based regimen can produce durable complete remissions in a subset of patients with MDS.
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Authors | S Yazji, F J Giles, A-M Tsimberidou, E H Estey, H M Kantarjian, S A O'Brien, R Kurzrock |
Journal | Leukemia
(Leukemia)
Vol. 17
Issue 11
Pg. 2101-6
(Nov 2003)
ISSN: 0887-6924 [Print] England |
PMID | 12931212
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Antilymphocyte Serum
- Immunosuppressive Agents
- Cyclosporine
- Methylprednisolone
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Topics |
- Adult
- Aged
- Antilymphocyte Serum
(therapeutic use)
- Blood Transfusion
- Cyclosporine
(therapeutic use)
- Female
- Hematocrit
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Karyotyping
- Male
- Methylprednisolone
(therapeutic use)
- Middle Aged
- Myelodysplastic Syndromes
(blood, drug therapy, genetics)
- Platelet Count
- Treatment Outcome
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