Amifostine in combination with erythropoietin and G-CSF promotes multilineage hematopoiesis in patients with myelodysplastic syndrome

Ineffective hematopoiesis leading to profound cytopenias represents a major clinical problem in the management of patients with myelodysplastic syndro me (MDS). The aminothiol amifostine has shown to promote multilineage hemat opoiesis both in vivo and in vitro in patients with MDS. We have treated 10 patients with 250 mg/m(2)amifostine thrice weekly in combination with eryt hropoietin for 4 consecutive weeks followed by 2 weeks observation. Respond ing patients received the same 6 week schedule, while nonresponder received G-CSF in addition to erythropoietin and amifostine during the second treat ment course. All patients experienced single or multilineage hematologic im provement. but only 2 reached transfusion independency. Moreover. response was durable only in a minority of patients and thus additional studies are warranted to further define the potential interaction of amifostine and gro wth factors.