Successful therapy of myelodysplastic syndrome with menatetrenone, a vitamin K-2 analog

Although vitamin K-2 is an inducer of the in vitro differentiation of myelo id leukemic cell lines, its clinical efficacy in the treatment of myelodysp lastic syndrome (MDS) is unclear. We administered a vitamin K-2 analog, men atetrenone, at 45 mg daily to an 80-year-old woman with MDS (refractory ane mia) heavily dependent on red-cell transfusions. The patient's pancytopenia gradually improved, and she became transfusion-independent after 14 months . Pancytopenia recurred when menatetrenone was discontinued but recovered a gain with readministration. Administration of menatetrenone at a dose effec tive in improving osteoporosis may also be useful in restoring hematopoiesi s in MDS patients, possibly by way of inducing differentiation. (C) 1999 Th e Japanese Society of Hematology.