Myelodysplastic syndromes in the elderly: The role of growth factors in management

Saba, Hussain I.

doi:10.1016/0145-2126(95)00131-x

Cited by 22 publications

(7 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Apart from its synergistic effects on erythropoiesis when combined with rhEPO, rhG-CSF is also used in patients with MDS to counteract neutropenia [171,172,[175][176][177][190][191][192][193]. In particular, G-CSF can be administered in patients with MDS to i) increase neutrophils during a severe (life-threatening) infection, ii) to prevent neutropenia-associated infections in those who are known to acquire severe (life threatening) infections (prophylactic use), and iii) as an adjunct to high dose chemotherapy [171,172,[175][176][177][190][191][192][193].…”

Section: Treatment With Hematopoietic Growth Factorsmentioning

confidence: 99%

“…In particular, G-CSF can be administered in patients with MDS to i) increase neutrophils during a severe (life-threatening) infection, ii) to prevent neutropenia-associated infections in those who are known to acquire severe (life threatening) infections (prophylactic use), and iii) as an adjunct to high dose chemotherapy [171,172,[175][176][177][190][191][192][193]. A generally accepted recommendation is to use G-CSF in neutropenic MDS patients who suffer from a severe (life-threatening) infection [172,[175][176][177]194]. Administration of rhGM-CSF may also be effective in these patients [173,174], and can be used in those who fail to respond to G-CSF, have developed anti-G-CSF antibodies, or show severe side effects (e.g.…”

Section: Treatment With Hematopoietic Growth Factorsmentioning

confidence: 99%

“…Cytokines that show beneficial effects in these patients include erythropoietin (EPO) [164][165][166][167][168][169][170], granuloyte colony-stimulating factor (G-CSF) [171,172,[175][176][177], and granulocyte-macrophage colony-stimulating factor (GM-CSF) [173][174][175][176][177].…”

Section: Treatment With Hematopoietic Growth Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Pathogenesis, classification, and treatment of myelodysplastic syndromes (MDS)

Valent

Wimazal

Schwarzinger

et al. 2003

Wien Klin Wochenschr

View full text Add to dashboard Cite

Myelodysplastic syndromes (MDS) comprise a heterogeneous group of clonal myeloid disorders characterized by morphologic dysplasia in one or more cell lineages. Dysplasia in MDS is associated with insufficient production of blood cells and consecutive cytopenia(s). The natural course and prognosis of MDS vary among patients and depend on genetic defects that occur during clonal evolution. In a significant group of patients (roughly 30%) progression to secondary leukemia is observed. These patients appear to have a grave prognosis. The treatment of patients with MDS has to be adjusted to the individual situation and age in each case. In many patients, control of blast cell production by palliative cytoreduction, continuous support with red blood cells, as well as other supportive measures, seem appropriate. In other patients, however, curative therapy (chemotherapy, stem cell transplantation) should be considered. The final decision to offer curative therapy must be based on many different factors including age and the overall situation of the patient. Recently established scoring systems aimed at predicting survival and evolution of leukemia in MDS may be helpful in this regard.

show abstract

Section: Treatment With Hematopoietic Growth Factorsmentioning

confidence: 99%

Section: Treatment With Hematopoietic Growth Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Pathogenesis, classification, and treatment of myelodysplastic syndromes (MDS)

Valent

Wimazal

Schwarzinger

et al. 2003

Wien Klin Wochenschr

View full text Add to dashboard Cite

show abstract

“…The most common hematological malignancy in older people is MDS [10]. The increased number of cases diagnosed is due mainly to an aging population and, more important, to clinicans' awareness of the syndrome and improvement in geriatric care [3].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Survival of Myelodysplastic Syndrome of the Refractory Anemia Type in Hospitalized Cognitively Different Geriatric Patients

Beloosesky¹,

Cohen

Grosman³

et al. 2000

Gerontology

View full text Add to dashboard Cite

Background: Myelodysplastic syndrome (MDS) is predominantly a disease of old age. The number of MDS cases diagnosed over the last 20 years has risen substantially due to increased awareness and improved geriatric care. Although MDS is increasingly diagnosed, the prevalence and prognosis of early-stage affected elderly are not completely known. Objective: To evaluate the prevalence, characteristics and prognosis of newly diagnosed MDS patients hospitalized in an acute and subacute geriatric department. Methods: Between 1993 and 1996, 3,275 patients hospitalized in the geriatric department of a teaching hospital for acute care or short-term rehabilitation were investigated for unexplained hematological abnormalities. Demographic, chronic comorbidities, cause of hospitalization, functional and cognitive status, hematological and other laboratory parameters were collected. Results: Two hundred and forty-five (7.5%) patients had unexplained cytopenia, macrocytosis or monocytosis, of whom 37 (15%) were diagnosed as having MDS. Only 9 patients were hospitalized for evaluation of anemia, 28 for infections, cardiac, cerebrovascular events and other causes. Thirty-four patients had refractory anemia (RA), two had RA with ringed sideroblasts and 1 had RA with an excess of blasts (RAEB). The follow-up period was up to 70 months. No differences were found between demented and cognitively normal patients in age, sex, comorbidities or laboratory parameters. Comparison of survival curves (excluding the RAEB case) according to demographic, clinical and hematological parameters has shown that only dementia adversely affects survival, compared to cognitively normal patients (p = 0.024). Conclusions: MDS of the RA type is a common and incidental finding in older hospitalized patients. It is a frequent cause of anemia and other hematological abnormalities but has less significance on survival rates than dementia, although its full impact remains to be determined.

show abstract

“…)I by the natural killer cells is obtained by exposing the cells to IL-2, IL-12, and IL-15 Leukemia is characterized by uncontrolled clonal expansion of leukemic progenitor cells arrested at a certain stage of differentiation. Cytokine abnormalities have been implicated in the onset and progression of various types of leukemia (5, 13, [25][26][27][28][29]. Defective proliferation of hematopoietic precursor cells could be at least in part due to an abnormal production of hematopoietic growth factors or a change in the precursor cell responsiveness to it.…”

mentioning

confidence: 99%

Leukemia Cells and the Cytokine Network

Moqattash

Lutton

1998

Experimental Biology and Medicine

View full text Add to dashboard Cite

The cytokine network plays an important role in the growth and differentiation of normal and leukemic cells. Stimulation of this network, which has positive and negative regulators, results in the induction or inhibition of certain hematopoietic events. A cytokine can have multiple effects on various cell types, and combinations of cytokines with each other or with other exogenous substances produce more pronounced effects than any cytokine or agent individually. The mechanisms by which cytokines affect normal and leukemic cell growth and viability may vary depending on the target cell or the cytokine(s) in question. Diseases such as leukemia may result from abnormalities in the cytokine network or their receptors. Cytokines play a major role in leukemogenesis. Normally, hematopoietic cells require certain cytokines for their viability and growth. When the viability factors are withdrawn, apoptotic cell death naturally occurs. Prevention of programmed cell death by the abnormal production of a cytokine may release the cell from normal growth control leading to malignant transformation. Disregulation of genes for hematopoietic growth factors and their receptors may be one of the events that leads to leukemogenesis through an aberrant autocrine growth mechanism. However, cytokines have been used as therapeutic agents in various ways. Differentiation therapy has been widely investigated and proven effective in certain types of cancer. Gene therapy, where the cytokine cDNA is used to reduce tumorigenicity and/or increase immunogenicity is promising. Another kind of therapy using alkylated growth factors has been under focus. This review summarizes the actions and interactions of cytokines that are related to leukemic cell viability and growth. The use of cytokines as therapeutic agents is also discussed.

show abstract

Myelodysplastic syndromes in the elderly: The role of growth factors in management

Cited by 22 publications

References 87 publications

Pathogenesis, classification, and treatment of myelodysplastic syndromes (MDS)

Pathogenesis, classification, and treatment of myelodysplastic syndromes (MDS)

Prevalence and Survival of Myelodysplastic Syndrome of the Refractory Anemia Type in Hospitalized Cognitively Different Geriatric Patients

Leukemia Cells and the Cytokine Network

Contact Info

Product

Resources

About