Biological and Pharmaceutical Bulletin
Online ISSN : 1347-5215
Print ISSN : 0918-6158
ISSN-L : 0918-6158

This article has now been updated. Please use the final version.

Effect of L-leucine Therapy on Hematopoietic Function in Elderly Myelodysplastic Syndrome Patients
Kaori Ito Takahiro HayashiYoko InagumaTomohiko TerazawaMaiko AndoYosuke AndoMasahiro TsugeAzusa KatoAkane ShimatoShinji SuzukiSayaka KatoAkihiro TomitaShigeki YamadaNobuhiko Emi
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JOURNAL FREE ACCESS Advance online publication

Article ID: b19-00184

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Abstract

Patients with myelodysplastic syndrome (MDS) often require blood transfusion and anticancer therapy; however, elderly patients are intolerant to the associated side effects of anticancer therapy. Because L-leucine can be used to treat Diamond–Blackfan anemia, which is caused by defects in ribosomal protein (RP) genes, resulting in increased in vivo hemoglobin synthesis, it is possible that some MDS patients who have aberrations in their RP genes could also be effectively treated with L-leucine. In the present study, we investigated the effects of L-leucine on hematopoietic function (reticulocyte count), red blood cell count, and hemoglobin level in MDS patients. We administered L-leucine (1.8 g, twice daily, 3 days/week) with oral vitamin B6 supplements to a final cohort of eight MDS patients for 15 (interquartile range: 11–18) weeks. We assessed the patients at 10 ± 2 weeks after therapy initiation. Only the absolute reticulocyte count was affected, improving in 6/8 (75%) patients. The median absolute reticulocyte count was 3.5 × 104 (range: 2.7-6.4 × 104) cells/μL, an increase of 0.5 × 104 (range: 0.2–0.7× 104) cells/μL. At 10 weeks, there was only one case of an improved hemoglobin level. Non-hematological adverse events of grade 3 were observed one raised triglycerides. These data suggest that L-leucine has little effect on MDS. However It may contribute to the recovery of hematopoietic function, futher study be desired.

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© 2019 The Pharmaceutical Society of Japan
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