Ribeiro Elisangela, Lima Carmen S P, Metze Konradin, Souza Carmino A, Lorand-Metze Irene
Department of Internal Medicine, Faculty of Medicine, State University of Campinas, Brazil.
In Vivo. 2003 Mar-Apr;17(2):181-4.
Clinical studies have shown that amifostine (AMF) improves peripheral cytopenias in myelodysplastic syndromes (MDS). We studied the expression of Fas/FasL on CD34+ cells in low risk MDS and its change after AMF treatment.
Patients received AMF 400 mg/m2 3x/week for 3 weeks and 2 weeks off treatment. Peripheral blood counts and BM cytology were analysed before and after 2 courses. Quantification of CD34+ cells and CD34/CD95 and CD34/CD95L ones were performed by flow cytometry.
Seventeen patients were treated. After 2 months, 8 patients showed a rise in neutrophil count. Hemoglobin increased in 1 and thrombocytes in 2 patients. Before treatment, responding patients presented a significantly lower expression of Fas (median 53%) and FasL (median 26%) than non-responders (85% and 70%, respectively). BM lymphocytes were significantly lower in responders (median 14.5% and 27.4%, respectively). In responders CD34+ cells decreased after treatment. The change in neutrophil count after treatment presented an inverse correlation with the percentage of BM lymphocytes before treatment (r = 0.0-0.58; p = 0.02).
Response to AMF may be influenced by the intensity of the immune reaction in BM.
临床研究表明，氨磷汀（AMF）可改善骨髓增生异常综合征（MDS）患者的外周血细胞减少。我们研究了低危MDS患者CD34+细胞上Fas/FasL的表达及其在AMF治疗后的变化。
患者接受AMF 400 mg/m2，每周3次，共3周，然后停药2周。在2个疗程前后分析外周血细胞计数和骨髓细胞学。通过流式细胞术对CD34+细胞以及CD34/CD95和CD34/CD95L细胞进行定量分析。
共治疗了17例患者。2个月后，8例患者中性粒细胞计数升高。1例患者血红蛋白升高，2例患者血小板升高。治疗前，有反应的患者Fas（中位数53%）和FasL（中位数26%）的表达明显低于无反应者（分别为85%和70%）。有反应者的骨髓淋巴细胞明显减少（中位数分别为14.5%和27.4%）。在有反应者中，治疗后CD34+细胞减少。治疗后中性粒细胞计数的变化与治疗前骨髓淋巴细胞百分比呈负相关（r = 0.0 - 0.58；p = 0.02）。
对AMF的反应可能受骨髓免疫反应强度的影响。
