MDS, 白血病および骨髄増殖性疾患に対する活性型ビタミンD<sub>3</sub>の治療効果

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タイトル別名
  • Therapeutic Effectiveness of Vitamin D<sub>3</sub> in Patients with Myelodysplastic Syndromes, Leukemias and Myeloproliferative Disorders
  • MDS,白血病および骨髄増殖性疾患に対する活性型ビタミンD3の治療効果
  • MDS ハッケツビョウ オヨビ コツズイ ゾウショクセイ シッカン ニ タイス

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We tried to treat 13 patients with myelodysplastic syndromes (MDS), leukemias and myeloproliferative disorders, with alfacalcidol for their hematological improvement. Eight of them had MDS, 2 acute leukemia (M3, M4), 1 chronic myelogenous leukemia and 2 primary myelofibrosis. All patients were untreated except for 3 patients (PASA, RAEB, AML-M4) who had been treated with mepitiostane, prednisolone and BH·AC-AMP regimen, respectively, prior to alfacalcidol therapy.<br>All patients received alfacalcidol orally for at least one month. The dosage of alfacalcidol ranged from 0.25 to 10 μg/day, and the medicine was administrated intermittently when the dosage exceeded 6 μg/day to prevent hypercalcemia.<br>The therapeutic effectiveness of alfacalcidol was evaluated according to a criteria by Koeffler (Cancer Treat Rep 69: 1399, 1985) with minor modifications. Three patients (PASA, RAEB, CMML) showed partial response, 3 (RAEB, RAEB in T, AML-M4) minor response and rest of the patients did not respond. The hematological improvement of 6 responders was transient (from 1 to 2 months), howewer, one patient (PASA) is still responding to alfacalcidol therapy (0.25 μg/day) for over 12 months.<br>The dysplastic features of hemopoietic cells in the bone marrow showed no noticeable change during the hematological improvement in these responders, suggesting the improvement was obtained as a result of alteration in the proliferation or differentiation of neoplastic clone.<br>None of 13 patients developed hypercalcemia. One patient (AML-M4) became excitable on high dose alfacalcidol (10 μg/day).<br>In conclusion, alfacalcidol therapy is effective in some patients with MDS or leukemias and appears worthy especially in the clinical state in which chemotherapy is not indicated.

収録刊行物

  • 臨床血液

    臨床血液 30 (1), 1-10, 1989

    一般社団法人 日本血液学会

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