EFFICIENCY OF ERYTHROPOIESIS-STIMULATING DRUGS IN ANEMIA IN PATIENTS WITH THE MYELODYSPLASTIC SYNDROME

The efficiency of erythropoiesis-stimulating drugs (EPSD) in the treatment of anemia was evaluated in 42 patients with the myelodysplastic syndrome (MDS). Epoietin a (n = 17) and epoietin 3 (n = 14) were administrated in a dose of 150 Units/kg 3 times weekly, darbepoietin a (n = 11) in a dose of 500 units once in 3 weeks (treatment duration median 5.5 months). The indication for EPSD was hemoglobin level < 100 g/I. Control group included 70 patients who did not receive EPSD. The efficiency of EPSD was evaluated by the erythrocytic response (ER) in accordance with IWG criteria. Increase of Hb concentration by 20 g/I in patients who did not receive red blood cells (RBC) transfusions or complete discontinuation of transfusions in previously RBC transfusion-dependent patients were considered as high ER. Increase of Hb concentration by 1019 g/I or 50% reduction of RBC transfusions dependence were regarded as minor ER. ER in the entire group was 35.7%: high ER in 11(26.2%) and minor in 4 (9.5%) patients. In controls minor response was attained in just 3 (4.3%) of 70 patients. An inverse correlation (r = -0.57; p < 0.05; n = 17) between the initial serum erythropoietin concentration and efficiency of EPSD therapy was detected. Positive response was attained in 60% patients with serum erythropoietin Concentration below 200 mUnit/ml. No positive response was attained at erythropoietin concentration above 500 mUnit/ml. Hence, the initial concentration of erythropoietin can be recommended as a prognostic factor for response to EPSD therapy in MDS patients.