Treatment of myelodysplastic syndromes with all-trans retinoic acid.
Leukemia Study Group of the Ministry of Health and Welfare
R Ohno, T Naoe, M Hirano, M Kobayashi, H Hirai, K Tubaki and H Oh
Department of Medicine, Nagoya University School of Medicine, Japan.
We treated 23 patients with myelodysplastic syndromes (MDS); 2 refractory
anemia (RA) with prior therapy, 11 RA with excess of blasts (RAEB), and 10
RAEB in transformation (RAEB-T), with daily oral 45 mg/m2 all-trans
retinoic acid (ATRA) in a multiinstitutional prospective study. In two
patients with RAEB and one with RAEB-T, a more than 1,000/microL increase
of peripheral neutrophil counts was observed with some reduction of blast
percentage in the bone marrow 2 to 9 weeks after the start of ATRA.
However, the effect was transient and did not last for more than 5 weeks
despite the continuation of ATRA therapy. In one other patient with RA, one
patient with RAEB, and one patient with RAEB-T, slight increase of
hemoglobin levels or reduction of blast percentage in bone marrow was
noted. Toxicities attributable to ATRA were minimal and included cheilitis,
xerosis, dermatitis, gastrointestinal disorders, abnormal liver function
tests, and high serum triglyceridemia. Although ATRA works remarkably as a
differentiation therapy in acute promyelocytic leukemia, its effect in MDS
included in this study was modest. Further study of this agent alone or in
combination may be warranted in less advanced stages of this disease.
Volume 81,
Issue 5,
pp. 1152-1154,
03/01/1993
Copyright © 1993 by The American Society of Hematology
