Bone Marrow Failure
AF List et al (Univ of Arizona, Tucson; US Bioscience, West Conshohocken, Pa) : Stimulation of Hematopoiesis by Amifostine in Patients with Myelodysplastic Syndrome.
Blood 90: 3364-3369, 1997.
The aminothiol, amifostine, is a cytoprotective agent that reduces the toxicities of anticancer treatment.
In 83% of patients given 3 times a week dosing, a single-lineage or multilineage hematologic response was seen. A 50% or greater increase in absolute neutrophil count was seen in 14 patients. In 43% of patients with thrombocytopenia, platelet counts increased. A 50% or greater decrease in need for transfusion was seen in 5 of 15 patients who were red-blood cell transfusion dependent. In 13 of 15 patients evaluated, assayable hematopoietic progenitors increased, including colony-forming unit (CFU)-granulocyte, erythroid, macrophage, and megakaryocyte; burst-forming units-erythroid; and CFU granulocyte-macrophage.
These results show that amifostine at 200 mg/m2 or less administered 3 times a week is well tolerated. Hematologic activity was seen in patients with myelodysplastic syndrome.
Sood R, Stewart CC, Aplan PD, et al [ Roswell Park Cancer Inst, Buffalo, NY]
Neutropenia Associated with T-Cell Large Granular Lymphocyte Leukemia : Long-term Response to Cyclosporine Therapy Despite Persistence of Abnormal Cells
Blood 91: 3372-3378, 1998
T-cell large granular lmphocyte [T-LGL] leukemia is clinically indolent disease associate with neutropenia in about half the patients.
In 5 patients of T-LGL with neutropenia were treated with cyclosporine at dose of 1 to1.5 mg/kg orally every 12 hours. Normal neutrophil counts were achieved in 4 patients treated with cyclosporine and fifth patient needed in addition low-dose GM-CSF. In 3 patients normal neutrophil counts were maintained with continued CSA treatment for 2,8 & 8.5 years. Despite resolution of neutropenia T-LGL cell persisted. This suggests that CSA may inhibit T-LGL secretion of unidentified mediators of neutropenia.
List AF, Brasfield F, Heaton R, et al [ Univ of Arizona, Tucson; US Bioscience West Conshohocken, Pa]
Stimulation of Hematopoiesis by Amifostine in Patients with Myelodysplastic Syndrome
Blood 90: 3364-3369, 1997
The aminothiol, amifostine, is a cytoprotective agent that reduces the toxicities of anticancer treatment.18 patients with myelodysplastic syndrome received amifostine in varying dose and schedules, in 83% of patients receiving 3 times a week dosing, a response was noted. These results revealed amifostine in dose of 200 mg/m2, 3 times a week is well tolerated and has some hematologic activity in patients with myelodysplastic syndrome. Immunosuppression by ATG or cyclosporine modulate the high rate apoptosis in MDS, increasing the survival of hematopoietic progenitors.