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Related Experiment Videos

Tumor necrosis factor-alpha levels decrease with anticytokine therapy in patients with myelodysplastic syndromes

S Reza1, V Shetty, S Dar

  • 1Rush Cancer Institute, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612-3515, USA.

Journal of Interferon & Cytokine Research : the Official Journal of the International Society for Interferon and Cytokine Research
|November 11, 1998
PubMed
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Myelodysplastic syndromes (MDS) patients with higher bone marrow Tumor Necrosis Factor-alpha (TNF-alpha) levels responded better to pentoxifylline and ciprofloxacin (PC) therapy. This PC therapy effectively reduced TNF-alpha levels over time.

Area of Science:

  • Hematology
  • Immunology
  • Oncology

Background:

  • Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.
  • Elevated levels of pro-inflammatory cytokines, such as Tumor Necrosis Factor-alpha (TNF-alpha), are implicated in MDS pathogenesis.
  • Understanding the role of TNF-alpha in MDS may reveal therapeutic targets.

Purpose of the Study:

  • To investigate the correlation between baseline TNF-alpha levels and treatment response in MDS patients.
  • To evaluate the efficacy of pentoxifylline and ciprofloxacin (PC) therapy, with or without dexamethasone (PCD), in reducing TNF-alpha levels.
  • To assess the impact of PC/PCD therapy on hematologic and cytogenetic parameters in MDS.

Main Methods:

  • Serum and bone marrow (BM) TNF-alpha levels were measured in 43 MDS patients using ELISA and immunohistochemistry, respectively.

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  • Patients received 12 weeks of PC therapy; nonresponders were offered additional dexamethasone (PCD).
  • Hematologic and cytogenetic responses were assessed, and BM TNF-alpha levels were tracked during therapy.
  • Main Results:

    • Eighteen of 43 patients achieved a hematologic or cytogenetic response.
    • Responders exhibited higher baseline BM TNF-alpha levels compared to nonresponders (median 3.5 vs. 2.0).
    • PC therapy significantly reduced BM TNF-alpha levels at 2, 8, and 12 weeks in the overall group; responders showed sustained reduction at 12 weeks.

    Conclusions:

    • Higher baseline BM TNF-alpha levels may predict a better response to PCD therapy in MDS patients.
    • PC/PCD therapy demonstrates sustained efficacy in reducing TNF-alpha levels in MDS.
    • Further research is needed to identify more potent suppressors of pro-apoptotic cytokines in MDS.