Antithymocyte globulin (ATG)-based therapy in patients with myelodysplastic syndromes. Leukemia 2003 Nov;17(11):2101-6
Date
08/22/2003Pubmed ID
12931212DOI
10.1038/sj.leu.2403124Scopus ID
2-s2.0-0242643661 (requires institutional sign-in at Scopus site) 78 CitationsAbstract
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.
Author List
Yazji S, Giles FJ, Tsimberidou AM, Estey EH, Kantarjian HM, O'Brien SA, Kurzrock RAuthor
Razelle Kurzrock MD Center Associate Director, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Antilymphocyte Serum
Blood Transfusion
Cyclosporine
Female
Hematocrit
Humans
Immunosuppressive Agents
Karyotyping
Male
Methylprednisolone
Middle Aged
Myelodysplastic Syndromes
Platelet Count
Treatment Outcome
