Abstract
Nineteen patients diagnosed as having myelodysplastic syndrome (MDS) were analysed for laboratory findings, treatment and prognosis. They were classified into four subtypes according to French-American-British (FAB) classification; 7 patients with refractory anemia (RA), 6 with refractory anemia with excess of blasts (RAEB), 5 with RAEB in transformation (RAEB in T), and one with chronic myelomonocytic leukemia (CMMoL).
The patients with RA had a relatively chronic clinical course only with a conservative therapy.
One patient with CMMoL has been successfully treated with administration of busulfan followed by esquinone and blood transfusion.
Three patients with RAEB or RAEB in T developed overt leukemia and survived for 1, 1, and 2.5 months after leukemic transformation. Remaining 3 patients with no leukemic transformation was also expired from infection. Their survival was only 1, 1, and 4 months.
In terms of treatment a low-dose Ara-C was given to 2 patients (RAEB, RAEB in T) and 4 patients (RAEB 2, RAEB in T 2) received recombinant gamma interferon. However, there was no good response. Anti-leukemic chemotherapy and bone marrow transplantation were also tried. One patient with RAEB obtained complete remission with a combination of vincristine, 6-MP and prednisolone lasting for 2 months. Bone marrow transplantation was performed on a 26 year-old RAEB in T patient with hematological improvement, but died of encephalitis. Thus far treatment for MDS is still a challenging problem. Pathogenesis of MDS and a well-defined treatment strategy should be investigated in the future.
