[Human recombinant erythropoietin in the treatment of myelodysplastic syndromes anemia. Meta-analytic study].

Abstract

PURPOSE:

To study the usefulness of different published epidemiological and analytic parameters to decide the treatment with human recombinant erythropoietin (rHuEPO) of anaemic patients with myelodysplastic syndromes (MDS).

PATIENTS AND METHODS:

We have revised 10 published series compiling 115 patients, studying age, sex, initial diagnosis, route of administration and posology, criteria of response, duration of the study, dosis with the response was obtained, response according to initial diagnosis, duration of responses, and effect of the treatment on other hematopoietic series. We have made a comparison between responders and non-responders based on epidemiological and analytical parameters.

RESULTS:

We have compiled 115 patients with a rate of global response of 23.5%. We have not found significative differences between the route (s.c. or i.v.) or frequency of administration, however the number of responses was higher when rHuEPO was administered three times weekly. A great variability in the criteria of response was observed among the different studies. Most of studies have a duration of three months but we have observed significative differences in the number of responses when the study is longer. We have not found significative differences between responders and non-responders with respect to age, sex, used dosis, transfusional dependency and degree of transfusional dependency, basal serum erythropoietin, time since diagnosis, transfusional period, haemoglobin level among non-transfusion dependent patients and haemoglobin level among transfusion dependent patients. We have found significative differences with respect to initial diagnosis, a higher rate of responses was observed in the refractory anaemia with excess of blasts (RAEB) group. We have not found a higher rate of transformations into acute myeloid leukaemia (AML) among these patients. The effects of the treatment on other haematopoietic series can be considered as anecdotical.

CONCLUSION:

The different epidemiological and analytic parameters published up to now are not useful in the decision of including an anaemic patient with MDS in the treatment with rHuEPO. Those patients with RAEB can be benefited with the treatment with rHuEPO. The concomitant use of other cytokines could improve these results.

• Authors: J N Rodríguez, J C Diéguez, R Muñiz, M L Martino, A Fernández-Jurado, A Amian, M Cañavate, D Prados
• Journal: Sangre (Sangre (Barc)) Vol. 39 Issue 6 Pg. 435-9 (Dec 1994) ISSN: 0036-4355 [Print] Spain
• Vernacular Title: Eritropoyetina recombinante humana en el tratamiento de la anemia de los síndromes mielodisplásicos. Estudio metaanalítico.
• PMID: 7855695 (Publication Type: English Abstract, Journal Article, Meta-Analysis)

Chemical References

• Recombinant Proteins
• Erythropoietin

Topics

• Anemia (etiology, therapy)
• Erythropoietin (administration & dosage, therapeutic use)
• Humans
• Myelodysplastic Syndromes (complications)
• Recombinant Proteins (administration & dosage, therapeutic use)
• Treatment Outcome