IMMUNOSUPPRESSIVE THERAPY FOR HYPOPLASTIC MYELODYSPLASTIC SYNDROME

BACKGROUND. Hypoplastic myelodysplastic syndrome (MDS) is characterize d by dysplasia and hypocellularity. The treatment of choice for young patients is bone marrow transplantation. METHODS. This report describe s the effect of immunosuppressive therapy in two patients with hypopla stic MDS for whom no suitable bone marrow donors were available. RESUL TS. Both patients had no human lymphocyte antigen-identical siblings a nd no suitable matched unrelated donor could be found. They received c yclosporin A (CsA), antithymocyte globulin (ATG), or a combination of the two. Treatment with CsA, ATG, or the combination led to clinical i mprovement (resolution of transfusion requirement), increase of bone m arrow cellularity, and the disappearance of dysplastic characteristics in the two patients with hypoplastic MDS. At the time of recurrence, this disease was still responsive to immunosuppressive therapy. CONCLU SIONS. Treatment with ATG and CsA can be an attractive alternative for patients with hypoplastic MDS for whom there is no possibility of bon e marrow transplantation (C) 1997 American Cancer Society.