Onkologie. 2010:4(2):101-105

Treatment of anaemia with erythropoiesis-stimulating proteins in patients with myelodysplastic syndrome

Magda Šišková

¹ . interní klinika –, hematoonkologie, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy v Praze

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): monotherapy with epoetin alpha or beta at standard doses (30,000–40,000 U per week), high doses

(60,000–80,000 U per week), monotherapy with 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), no substantial difference

was observed in the response rates to monotherapy with epoetin alpha and darbopoetin (57.6 % vs. 59.4 %); 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 MDS patients with a low risk (low or medium IPSS score), a low level of endogenous EPO

(< 500 IU/L) and little or no need for transfusions (≤ 2 TU erythrocytes/month).

Keywords: myelodysplastic syndrome, anaemia, erythropoetin, epoetin, darbopoetin, granulocyte colony-stimulating factor

Published: May 1, 2010  Show citation