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Role of High-Intensity Therapy Followed By G-CSF for Patients With Advanced Myelodysplastic Syndrome: Presented at MDS By Isabel Ortega NAGASAKI, JAPAN -- September 22, 2005 -- Intensive chemotherapy followed by granulocyte colony-stimulating factor (G-CSF) might improve the results normally seen with standard chemotherapy in patients with myelodysplastic syndrome (MDS), researchers reported here at the 8th International Symposium on Myelodysplastic Syndromes (MDS), held on May 12th through to the 15th. MDS is a clonal haematopoietic disorder that is associated with poorer response to standard chemotherapy than are seen in patients with de novo acute myelogenous leukaemia. G-CSF is a potent haematopoietic factor shown to enhance survival and drive differentiation of myeloid lineage cells, resulting in generation of neutrophilic granulocytes. Shinsuke Yano, MD, radiation oncologist, department of internal medicine, Jikei University, Tokyo, Japan, and colleagues hypothesised that intensive chemotherapy followed by granulocyte colony-stimulating factor (G-CSF) might improve the results compared with standard chemotherapy. The researchers conducted a study of 114 patients with MDS who were diagnosed between August 1987 and August 2004. Their median age was 61.5 years and patients were followed for a median of 90.7 months. A total of 55 patients had refractory anaemia (RA), 24 had RA with excess blasts (RAEB), 13 had RAEB in transformation, 16 had overt leukaemia, 5 had chronic myelomonocytic leukaemia (CMML), and 1 had RA with ring sideroblasts (RARS). Of 20 patients who were treated with high-intensity therapy followed by G-CSF, 40% achieved complete remission. Among the 36 patients treated with high-intensity or low-intensity therapy but no G-CSF, 17% patients had complete remissions. Seven patients who were in complete remission and 5 who did not achieve complete remission were treated with allogeneic stem cell transplantation. After 5 years, the rate of disease-free survival was 80% in the first group and 40% in the second group. Although few patients with advanced MDS were cured with conventional chemotherapy, high-intensity chemotherapy followed by G-CSF may have a better chance of changing the natural history of the disease, the researchers concluded. They noted that allogeneic stem cell transplantation for patients in complete remission might improve outcomes. [Presentation title: Role of High-Intensity Therapy Followed By G-CSF for Patients With Advanced Myelodysplastic Syndrome. Abstract O-66] E-mail this page to a friend or colleague! To print, use this version