SERUM ERYTHROPOIETIN LEVEL AND MARROW ERYTHROID INFILTRATION PREDICT RESPONSE TO RECOMBINANT-HUMAN-ERYTHROPOIETIN IN MYELODYSPLASTIC SYNDROMES

Background and Methods. In 38 patients with myelodysplastic syndromes (MDS) the values of serum erythropoietin were measured at diagnosis an d compared with the haemoglobin level. A highly significant inverse re lationship was found between these two parameters, suggesting that the physiologic mechanism of erythroid progenitor cell recruitment is pre served in MDS. Fourteen transfusion-dependent patients were treated wi th recombinant human erythropoietin at the dose of 150 U/Kg three time s weekly for at least 2 months. Results and Conclusions. Under recombi nant human erythropoietin, three patients became transfusion-independe nt and 5 had a transient decrease of their transfusion requirement. Tw o patients under prolonged treatment at the same dose of erythropoieti n remain in complete remission after 12 and 15 months respectively. A direct relationship between response to erythropoietin treatment and d egree of bone marrow erythroid hyperplasia, coupled to an inverse corr elation between response to erythropoietin and baseline serum erythrop oietin levels were noted. Based on these findings, recombinant human e rythropoietin may represent an effective treatment modality for select ed patients with MDS.