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Remicade as TNF suppressor in patients with myelodysplastic syndromes
1Section of Myeloid Diseases, Rush University, Chicago, IL 60612-3515, USA. azra_raza@rush.edu
Leukemia & Lymphoma
|September 17, 2004
Summary
Remicade (infliximab) showed potential in treating low-risk myelodysplastic syndromes (MDS). This tumor necrosis factor alpha inhibitor was well-tolerated, with some patients achieving hematologic responses and minor cytogenetic improvements.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.
- Low-risk MDS is characterized by ineffective hematopoiesis and cytopenias.
- Tumor necrosis factor alpha (TNF-α) plays a role in MDS pathogenesis.
Purpose of the Study:
- To evaluate the safety and efficacy of Remicade (infliximab) in patients with low-risk myelodysplastic syndromes.
- To assess hematologic and cytogenetic responses to Remicade treatment.
Main Methods:
- A total of 37 low-risk MDS patients were enrolled in two cohorts, receiving Remicade at 5 mg/kg or 10 mg/kg intravenously every 4 weeks for 4 cycles.
- Response was evaluated using International Working Group criteria in 28 patients who completed therapy.
- Safety and tolerability were assessed throughout the study.
Main Results:
- Eight patients (28/28) showed hematologic responses, with response rates of 20% in cohort 1 and 38% in cohort 2.
- Responses included multi-lineage improvements, increased absolute neutrophils, hemoglobin, and blast reduction.
- Two patients achieved minor cytogenetic responses.
Conclusions:
- Remicade demonstrates potential activity in low-risk MDS patients.
- The treatment was well-tolerated with high patient compliance.
- Remicade may be considered for future combination therapy in MDS management.