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- Title
Sequential combination of thalidomide and erythropoietin determines transfusion independence and disease control in idiopathic myelofibrosis previously insensitive to both drugs used as single agents.
- Authors
Visani, G; Mele, A; Malagola, M; Isidori, A; Finelli, C; Piccaluga, P P
- Abstract
Idiopathic myelofibrosis (IMF) is a chronic myeloproliferative disorder characterized by bone marrow fibrosis, extramedullary hematopoiesis, splenomegaly, anemia and peripheral blood leukoerythroblastosis. The stromal proliferation is a reactive phenomenon, caused by intramedullary release of cytokines such as platelet-derived growth factor, transforming growth factor-beta, basic fibroblast growth factor, epidermal growth factor and calmodulin. Thalidomide retains antiangiogenic, immunomodulatory and cytokine regulatory properties and these activities have suggested a potential therapeutic role in IMF. Recombinant human erythropoietin has also been used for the treatment of transfusion-dependent anemia, and recent results suggest that patients with low basal serum erythropoietin and low transfusional dependency have a better response. The combined treatment has not been able to reduce markedly the amount of reticulin fibers. However, it has to be underlined that bone marrow cellularity markedly increased, with normal morphology of megakaryocytes.
- Subjects
MYELOFIBROSIS; THALIDOMIDE; ERYTHROPOIETIN; THERAPEUTICS
- Publication
Leukemia (08876924), 2003, Vol 17, Issue 8, p1669
- ISSN
0887-6924
- Publication type
Article
- DOI
10.1038/sj.leu.2403017