Treatment of anaemia with erythropoiesis-stimulating proteins in patients with myelodysplastic syndrome
Abstract
Anaemia is the most common manifestation of myelodysplastic syndrome (MDS).In addition to replacement therapy, MDS-related anaemia can also be managed with erythropoiesis-stimulating proteins (ESPs) in monotherapy or in combination with granulocyte colony-stimulating factor (G-CSF): epoietin alfa or beta in standard doses(30,000–40,000 U weekly), high doses (60,000–80,000 U weekly), darbopoetin (150–300 mcg per week) or in combination with G-CSF (300–600 mcg per week). When erythroid response rates were evaluated using the International Working Group criteria (IWGc), there was a statistically significant difference in both groups compared to patients with supportive care.
The combination with G-CSF particularly increases the response rates in patients with RARS (up to 70 %) and affects the survival compared to untreated patients. The best response to ESP treatment (with or without G-CSF) was found in low risk MDS patients(IPSS 0-1),low level of endogenous EPO (< 500 U) and need </= 2 TU EBR per mon