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目的:探讨环孢素治疗红系增生减低骨髓增生异常综合征(MDS)的疗效与安全性。方法:5例患者经血常规、骨髓细胞形态学、免疫表型及染色体检查诊断为红系增生减低MDS,给予环孢素治疗,剂量为100~200 mg/d。根据国际工作组2006疗效标准进行疗效评价,参照不良事件常用术语标准3.0版对不良反应进行评定。结果:5例病人中男性3例,女性2例,年龄47~71岁,中位年龄56岁。治疗1个月5例患者均获红系血液学改善,治疗后3个月4例患者(另1例患者只观察1个月)血红蛋白为94~146 g/L,平均118 g/L。3例患者血红蛋白一直处于稳定水平,1例患者治疗3个月后自行停药,血红蛋白迅速降至治疗前水平,继续服药后又逐渐升至正常水平。5例患者出现6例次不良反应,包括牙龈肿胀(n=3)、多毛症(n=2)及皮肤色素沉着(n=1),但未出现≥3级的不良反应。结论:初步研究结果表明,环孢素治疗红系增生减低MDS安全有效。
Objective: To investigate the efficacy and safety of cyclosporin in treating erythroid hyperplasia and reducing myelodysplastic syndrome (MDS). Methods: Five patients were diagnosed as erythroid hyperplasia and MDS by blood routine, bone marrow cell morphology, immunophenotype and chromosome examination. The patients were treated with cyclosporine at a dosage of 100-200 mg / d. According to the International Working Group 2006 curative effect evaluation, according to the common terminology standard of adverse events version 3.0 to assess the adverse reactions. Results: Among the 5 patients, 3 were males and 2 females, aged 47-71 years, with a median age of 56 years. Hemoglobin was improved in all 5 patients after treatment for one month. Hemoglobin (94-146 g / L, average 118 g / L) was found in 4 patients (only 1 patient was observed in 1 patient) 3 months after treatment. Three patients had hemoglobin at a stable level. One patient discontinued on his own after three months of treatment. Hemoglobin rapidly dropped to the pre-treatment level and continued to rise to normal levels after continued administration. There were 6 adverse reactions in 5 patients including gingival swelling (n = 3), hirsutism (n = 2), and skin pigmentation (n = 1), but no grade ≥3 adverse reactions were noted. Conclusion: The preliminary results show that cyclosporine erythroid hyperplasia reduce MDS safe and effective.