[Our experiences in the treatment of myelodysplastic syndromes]

From 1987 an abrupt increase of the number of patients presented with MDS has been registered. We present our experiences in the treatment of 42 patients. The number of the male patients was two times larger than of the females. They were most frequently diagnosed as having RAB (43%) and RAEBt (28.5%). RA was found in 14%, RARS in 9.5% and CMML. in only 5% of the cases. The treatment was accomplished with ultralow (3 mg/m2/12h s.c.) and low doses (10 mg/m2/12h s.c.) of ARA-C in 75% of the patients with RAEBt and 44.4% with RAEB, while the CMML group received hydroxyurea. The treatment improved hematologic results but the complete remission lacked. In 23.8% of the cases the disease developed into acute nonlymphoblastic leukemia. Patients excepted from cytostatic therapy were observed by the use of androgens, anabolics, vitamin A+D3 and transfusion of separated erythrocytes. In 38% of the patients with MDS a lethal outcome followed. Life of those in whom the disease developed into acute leukemia in statistically significatly shorter (p < 0.05). There was no statistically significant difference in the survival rate between the treated and nontreated patients (p > 0.05). Further treatment of these patients includes, apart from ultralow doses of ARA-C, the use of retinoic acid, a growth factor (GM-CSF) and bone marrow transplantation.