Predictors of Stenke et al for the Response to Erythropoietin in a Patient with a Myelodysplastic Syndrome

 

Dose of erythropoietin: 150 U per kg given subcutaneously three times per week for 6 weeks.

Feature	Responder	Nonresponder
serum erythropoietin	low	high
transfusion	independent	dependent
gender	female	male
type of myelodysplasia	refractory anemia (RA)	refractory anemia with excess of blasts (RAEB)
karyotype	normal or 5q-	other

 

Serum erythropoietin:

• Normal range: 5-19 U/L

• Responders had levels 92+/-33

• Nonresponders: 515+/-108

• According to Figure 1 (page 1325) the highest level for a responder was about 300 U/L with most < 100 U/L. About half the nonsresponders were in the same range, while the other half were >= 500 U/L

• A serum level >= 380 U/L (20 times upper limit of normal) would favor nonresponse.

 

The nonresponder shows features suggesting a shorter survival and greater probability of progressing to AML.