Hernández-Boluda Juan-Carlos, Martínez-Trillos Alejandra, García-Gutiérrez Valentín, Ferrer-Marín Francisca, Xicoy Blanca, Alvarez-Larrán Alberto, Kerguelen Ana, Barba Pere, Gómez Montse, Herrera Juan-Carlos, Correa Juan-Gonzalo, Cervantes Francisco
a Hematology and Medical Oncology Department, Hospital Clínico Universitario , Valencia , Spain.
b Hematology Department, Hospital Clínic , IDIBAPS, University of Barcelona , Barcelona , Spain.
Leuk Lymphoma. 2016;57(1):120-4. doi: 10.3109/10428194.2015.1046866. Epub 2015 Jun 18.
This study has retrospectively analyzed the efficacy of single-agent prednisone, usually given after failure of other therapies, in 30 patients with myelofibrosis (MF) and severe anemia. Initial dose was 0.5-1 mg/kg daily, with tapering to the minimum effective dose in responders. Twelve patients (40%) achieved anemia response according to the revised International Working Group for Myelofibrosis Research and Treatment criteria, after a median time of 1.1 months on treatment. Median response duration was 12.3 months. Patients with constitutional symptoms or > 2% circulating blasts had a trend for a lower response rate. A platelet increase > 50 × 10(9)/L was observed in three out of 11 patients with baseline counts < 100 × 10(9)/L. Median survival from prednisone start was significantly longer in anemia responders (5.0 years, 95% CI = 3.5-6.5, vs 1.5 years, 95% CI = 0.2-2.8; p = 0.002). Prednisone can improve the anemia and thrombocytopenia in selected MF patients after failure to standard therapies.
本研究回顾性分析了通常在其他治疗失败后给予的单药泼尼松对30例骨髓纤维化（MF）合并严重贫血患者的疗效。初始剂量为每日0.5 - 1mg/kg，对有反应者逐渐减量至最低有效剂量。根据修订的国际骨髓纤维化研究和治疗工作组标准，12例患者（40%）在治疗中位时间1.1个月后达到贫血反应。中位反应持续时间为12.3个月。有全身症状或循环原始细胞>2%的患者反应率有降低趋势。11例基线计数<100×10⁹/L的患者中有3例血小板增加>50×10⁹/L。从开始使用泼尼松起，贫血反应者的中位生存期显著更长（5.0年，95%CI = 3.5 - 6.5，对比1.5年，95%CI = 0.2 - 2.8；p = 0.002）。在标准治疗失败后，泼尼松可改善部分MF患者的贫血和血小板减少情况。
