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ISSN 0016-3813 (Print)

2015, Number 3

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Gac Med Mex 2015; 151 (3)

Hematologic response predictor factors in adults with myelodysplastic syndromes (SMD) treated with cyclosporin A (CSA)

Zamora-Pérez E, López-Karpovitch X

Language: Spanish
References: 42
Page: 345--353
PDF size: 255.63 Kb.


ABSTRACT

Background: Myelodysplastic syndromes (MDS) are clonal diseases of hematopoietic cells. The International Prognostic Scoring System (IPSS) is the risk scale most employed in MDS. Cyclosporin A (CsA) has been used in the treatment of cytopenias in MDS. Objective: To evaluate hematologic response and identify response predictive factors in adults with MDS treated with CsA. Material and methods: Patients with MDS diagnosed according World Health Organization (WHO) classification were recruited from January 1997 to June 2012. All patients were classified with IPSS, IPSS revised (IPSS-R), WHO Prognostic Scoring System (WPSS), and WPSS revised (WPSS-R) risk scales. Cyclosporin A was administered orally at a dose of 5 mg/kg/day. Hematologic response was evaluated following the International Working Group for MDS (2006 version) criteria. Results: Inclusion criteria were met by 32 patients. Median age was 56.5 years, with a median follow-up of 3.1 years. Hematologic response was 56.2% and erythrocyte independence transfusion was found in 42.9% of patients. Age, hemoglobin level, and WPSS at diagnosis were independent predictive factors for CsA response. Survival was longer in responder than in nonresponder CsA patients (p = 0.06). Conclusions: Cyclosporin A induced hematologic response in › 50% of patients with MDS aged ‹ 57 years, with Hb ‹ 8 g/dl and low WPSS at diagnosis.


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