Which medications in the drug class Hematopoietic Growth Factors are used in the treatment of Myelodysplastic Syndrome?

Updated: Jul 24, 2018
  • Author: Emmanuel C Besa, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Answer

Hematopoietic Growth Factors

Ineffective blood cell production is due to excess cellular apoptosis (programmed cell death) caused by activation of the Fas-Fas ligand. Hematopoietic growth factors are capable of reversing this process to some extent.

Epoetin alfa (Procrit, Epogen)

Epoetin alfa is a glycoprotein that stimulates red blood cell (RBC) production by stimulating division and maturation of committed RBC precursor cells. It is effective in 20-26% of MDS patients when administered alone and in as many as 48% of patients when combined with granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF).

Darbepoetin (Aranesp)

Darbepoetin is an erythropoiesis-stimulating protein closely related to erythropoietin, a primary growth factor that is produced in the kidney and stimulates development of erythroid progenitor cells in bone marrow. This agent's mechanism of action is similar to that of endogenous erythropoietin, which interacts with stem cells to increase red cell production.

Darbepoetin differs from epoetin alfa (recombinant human erythropoietin) in containing 5 N-linked oligosaccharide chains, whereas epoetin alfa contains 3. Darbepoetin has a longer half-life than epoetin alfa, and may be administered weekly or biweekly.

Sargramostim (Leukine)

This GM-CSF stimulates division and maturation of earlier myeloid and macrophage precursor cells. It has been reported to increase granulocytes in 48-91% of patients with MDS.

Filgrastim (Neupogen, Granix)

This G-CSF stimulates division and maturation of granulocytes, mostly neutrophils, in 75-100% of MDS patients and seems to enhance erythroid response when given in combination with erythropoietin.


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