Prognostic markers of efficiency of immunosupressive therapy in patients with myelodysplastic syndrome
DOI:
https://doi.org/10.15587/2313-8416.2015.50513Keywords:
myelodysplastic syndrome, cyclosporine A, cytokine, marrowAbstract
Introduction: There is no “gold standard” of the treatment of myelodysplastic synfrom (MDS) for today. Use of the different directions of therapy at MDS is caused by the prognosis of clinical course, age and general state of patient, donor presence and possibility for an adequate attendant therapy. That is why the search of standards of treatment at MDS continues
Aim: To analyze an efficiency of the therapy with cyclosporine A in patients with MDS of the low risk and to detect the new prognostic factors of response to treatment.
Methods: 25 patients with MDS RA were examined according to FAB-classification, 15 women and 10 men whose mean age was 55 years. Statistical analysis of material was carried out using packages of applications STATISTICA for Windows 5,0 and NCSS. Parametric indicators were described as a median [lower-upper quartile] (minimum-maximum). The dynamics of parametric indicators in every group was assessed using Wilcoxon criterion.
Results: During the treatment with cyclosporine A the complete clinical and hematological remission was received in 28 % of patients, the partial remission was fixed in 25 % of patients and hematological improvement according to criteria of the system of International working group (IWG) – in 28 % of treated patients. It was revealed the reliable decrease of TNF-α, TGF-β and IL-6 in the process of treatment that prove the target mechanism of an effect of preparation at myelodysplastic syndrome. An influence of cytokines on the probability of positive result of treatment was not confirmed. It was established that the young age of patients, hypo- or normocellular marrow, an increased rate of lymphocytes in myelogram, an absence of hemotransfusion dependence and the level of hemoglobin higher than 80 g/l cause the better response to treatment with cyclosporine A. TNF-a concentration higher than 8 mg|ml is a marker of an early relapse in patients treated with cyclosporine A
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Copyright (c) 2015 Ольга Ігорівна Бойко, Звенислава Володимирівна Масляк, Звенислава Володимирівна Масляк, Ярослава Іллівна Виговська, Ярослава Іллівна Виговська, Мар’яна Іванівна Сімонова, Мар’яна Іванівна Сімонова, Наталія Яремівна Томашевська, Наталія Яремівна Томашевська
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