Table 1.
MDS drug/dosing schedule | Indication | Response | Duration (months) | Studies |
---|---|---|---|---|
ESAs | Lower- risk MDS | 40% OR | 24 | Golshayan et al. [2007] |
Epoetin | Survival benefit | Park et al. [2008] | ||
40,000–80,000 units | Jadersten et al. [2008] | |||
weekly | Gabrilove et al. [2008] | |||
Darbepoetin | ||||
100–500 μg every 1–3 | ||||
weeks | ||||
ESAs + G-CSF | Lower- risk MDS | 40–50% OR | 11–24 | Negrin et al. [1996] |
Epoetin | Hellstrom-Lindberg et al. [1997, 2003] | |||
10,000 units 5 days a | ||||
week | Casadevall et al. [2004] | |||
Filgrastim | Greenberg et al. [2009] | |||
75–300 μg/day 3 | ||||
times a week | ||||
Lenalidomide | Lower-risk MDS with del(5q) | 67% transfusion independence | >24 | List et al. [2006] |
10 mg/day for 21–28 | ||||
days of a 28-day cycle | 45% cytogenetic CR | |||
73% PR | ||||
No survival benefit | ||||
Lenalidomide | Lower-risk MDS non-del(5q) | 26% transfusion independence | 9.6 | Raza et al. [2008] |
10 mg/day for 21–28 | ||||
days of a 28-day cycLe | 29% OR in no previous ESA use group | |||
Romiplostim | Lower-risk MDS with thrombocytopenia | 30–46% durable platelet response | 4.6 with weekly schedule | Kantarjian et al. [2010] |
500 or 750 μg SC/QW 750 μg in three different dosing schedules: subcutaneous weekLy or biweekly, intravenous biweekly | Sekeres et al. [2010a] |
ESA, erythropoiesis-stimuLating agent; G-CSF, granulocyte colony stimulating factor; IWG, International Working Group; MDS, myelodysplastic syndromes; OR (CR + PR), overall response (complete response + partial response); OS, overall survival; PR, partial response.