Treatment of patients with myelodysplastic syndrome with amifostine

Abstract 

The efficacy and toxicity of amifostine (300 mg/m² three times a week for three consecutive weeks for a maximum of six courses) was evaluated in 12 patients with primary myelodysplastic syndromes. Dose escalation up to 400 mg/m² was allowed to patients who failed to response. Hemoglobin concentration was increased ≥1.5 g/dl on two (18%) of the 11 anemic patients. These two patients obtained transfusion indepedence for 20 weeks. Reticulocyte counts and ANC increased ≥50% of baseline in four (44%) of the nine patients with reticulocytopenia and in three (25%) of the 12 neutropenic patients. Platelet count increased in three (50%) of the six patients with thrombocytopenia. Progenitor growth of CFU-GMs and BFU-Es improved in 8/12 patients. No major side effects were observed. In conclusion amifostine is well tolerated and can promote the growth of primitive hematopoietic progenitors and ameliorate the cytopenias in MDS patients.

Keywords:  Myelodysplastic syndrome, Amifostine, Treatment, Response, Hematopoiesis

Abbreviations:  AMF, amifostine, AML, acute myeloid leukemia, ANC, absolute neutrophil count, BFU-Es, burst forming units-erythroids, BM, bone marrow, CBC, complete blood count, CFU-GMs, colony-forming unit-granulocyte-macrophages, CMML, chronic myelomonocytic leukemia, FAB, French-American-British, G-CSF, granulocyte colony-stimulating factor, Hb, hemoglobin, IPSS, international prognostic scoring system, MDS, myelodysplastic syndromes, PLT, platelets, RA, refractory anemia, RAEB, RA with excess of blasts, RARS, RA with ringed sideroblasts, RET, reticulocyte, rh-Epo, recombinant human erythropoietin, rh-GM-CSF, rh granulocyte macrophage colony-stimulating factor, TNF-α, tumor necrosis factor alpha