Clinical use of cytokines in the treatment of myelodysplastic syndrome (MDS): A review

Myelodysplastic syndrome (MDS) is a frustrating disorder which until recently lacked effective treatment. Patients usually succumb to infection, bleeding complications, and/or progression to acute leukemia. Recombinant cytokines, such as granulocyte‐macrophage colony‐stimulating factor (GM‐CSF), granulocyte (G) CSF, interleukin (IL) 3 and erythropoietin (Epo), have now been used to ameliorate the cytopenias associated with this disease. Small clinical trials in MDS patients using cytokines with myeloid activity (G‐CSF, GM‐CSF, IL‐3) have shown consistent elevations in the WBC counts with little success in elevating hemoglobin or platelets. Epo is able to increase the hemoglobin in a small group of MDS patients. Future trials utilizing combinations of these cytokines may lead to multilineage effects.