methenolone and Primary-Myelofibrosis

Topics: Blood Cell Count; Danazol; Hematopoietic Stem Cell Transplantation; Humans; Hydroxyurea; Japan; Methenolone; Palliative Care; Prednisolone; Primary Myelofibrosis; Prognosis; Radiotherapy; Spleen; Survival Rate; Transplantation Conditioning

Between 1999 and 2005, 285 patients received new diagnoses of myelofibrosis with myeloid metaplasia (MMM) in Japan. Anemic symptoms were present in 162 patients, and hemoglobin (Hb) concentrations were <10 g/dL in 197 patients. Fifty-five MMM patients were treated with anabolic steroids, and their effect on anemia during MMM was evaluated in 39 patients. A "good" response was defined as an Hb increase of >or=1.5 g/dL, cessation of transfusion dependence, and an Hb concentration of >10 g/dL maintained for at least 8 weeks. A "minimum" response was defined as an Hb increase of >or=1.5 g/dL and transfusion independence for at least 8 weeks. Both good and minimum responses were considered "favorable." Favorable responses were achieved in 17 patients (44%, 8 good and 9 minimum responses). None of the pretreatment variables, such as the lack of transfusion dependence, a higher Hb concentration at the start of treatment, or the absence of cytogenetic abnormalities, were associated with a response to anabolic steroid therapy. Adverse events associated with anabolic steroid therapy were moderate and transient. Two patients required definitive withdrawal of treatment. Thus, anabolic steroids are well tolerated and effective for the treatment of anemia in a subset of MMM patients.

Topics: Adult; Aged; Aged, 80 and over; Anabolic Agents; Anemia; Blood Transfusion; Chromosome Aberrations; Danazol; Estrogen Antagonists; Female; Hemoglobins; Humans; Male; Methenolone; Middle Aged; Primary Myelofibrosis; Time Factors

A therapeutic trial with methenolone (Primobolan) in 19 consecutive patients with different types of refractory anemia is reported. The remission frequencies were: pancytopenia 3/6, bicytopenia 2/4, refractory anemia with hyperplastic marrow 1/5, myelofibrosis 1/4. There was no obvious prolongation of survival in the patients responding. Side-effects were negligible.

Topics: Aged; Agranulocytosis; Anemia, Aplastic; Chemical and Drug Induced Liver Injury; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Liver; Male; Methenolone; Middle Aged; Pancytopenia; Primary Myelofibrosis; Remission, Spontaneous; Virilism

Three cases of primary myelodysplastic syndrome (MDS) associated with myelofibrosis were initially diagnosed as refractory anemia by the presence of bicytopenia or pancytopenia and having normo- or hypercellular marrow with dysplastic features. The bone marrow aspiration of these patients showed dry tap a few months after admission, or on admission. Their bone marrow biopsy specimens revealed various grades of increased formation of reticulin fibers. One patient entered into complete remission in response to metenolone, while the other two patients died of cerebral hemorrhage several months after admission. These results indicate that this disease should be classified as a distinct subgroup of MDS.

Topics: Aged; Bone Marrow; Diagnosis, Differential; Fatal Outcome; Female; Hematopoiesis; Humans; Liver; Male; Methenolone; Middle Aged; Myelodysplastic Syndromes; Primary Myelofibrosis; Spleen