Cytokine therapy for myelodysplastic syndrome

The myelodysplastic syndromes are a heterogenous family of hematologic diso rders characterized by ineffective hematopoiesis, Because of the interpatie nt variability regarding prognosis and morbidity, management of myelodyspla stic syndromes continues to be a challenge to clinical hematologists. Pancy topenia and defective function of neutrophils and platelets carry a high ri sk of infectious or hemorrhagic complications. Erythropoietin is perhaps th e most commonly used therapeutic option, second only to transfusion; improv ement of erythropoiesis is seen in approximately 20% of patients, mainly in those with relatively preserved erythroid function and no or low transfusi on requirements. Coadministration of erythropoietin with either granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating fac tor may increase the response rate up to 50%. Although prophylactic adminis tration of granulocyte- or granulocyte-macrophage colony-stimulating factor cannot be recommended, treatment of febrile neutropenia might benefit from administration of granulocyte- or granulocyte-macrophage colony-stimulatin g factor in addition to antibiotics. (C) Lippincott Williams & Wilkins, Inc .