ABSTRACT
AIM: To estimate a change in myelodysplasia in decitabine-treated patients with myelodysplastic syndromes (MDS). SUBJECTS AND METHODS: Thirteen MDS patients from a high-risk group were examined; 75 bone marrow puncture specimens and 67 bone marrow trepanobiopsy specimens from these patients were analyzed before and after decitabine treatment. Dysplastic changes in the hematopoietic cells were monitored during the treatment. RESULTS: The dysplastic changes in the hematopoietic cells are a morphological portrayal of the ineffective hematopoiesis in patients with MDS. The study has indicated that the use of the hypomethylating agent decitabine promotes the restoration of cell differentiation to mature forms, causing hematopoiesis to be more effective. The incidence of myelodysplasias (including mixed double- and triple-lineage ones) was statistically significantly reduced by decitabine treatment, which was associated with a positive response to treatment as a whole. The count of cells with dysplastic features remained unchanged in patients with therapy resistance or further disease progression. CONCLUSION: Analysis of myelodysplastic manifestations in different hematopoietic lineages in patients with MDS should be based on the comprehensive dynamic assessment of cytological and histological parameters at both the primary diagnosis of the disease and different stages of treatment. With a response to decitabine therapy (as shown by the results of aspiration and trepanobiopsy), all cell lines displayed reduced myelodysplastic changes, indirectly indicating a decrease of the abnormal clone itself in high-risk MDS patients.
Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Azacitidine/analogs & derivatives , Myelodysplastic Syndromes/drug therapy , Myelodysplastic Syndromes/pathology , Myelopoiesis/drug effects , Adult , Aged , Antimetabolites, Antineoplastic/administration & dosage , Antimetabolites, Antineoplastic/adverse effects , Azacitidine/administration & dosage , Azacitidine/adverse effects , Azacitidine/therapeutic use , Decitabine , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Infusions, Intravenous , Male , Middle Aged , Prospective Studies , Treatment Outcome , Young AdultABSTRACT
The authors analyze the efficacy of He-Ne laser therapy of amblyopia of various origins in 48 children (81 eyes). Group 1 children were not treated at all in order to assess the visual function background fluctuations (absolute controls). Along with He-Ne laser, used in Group 2, a 'placebo', slit lamp with blinking light, was used in Group 3. Vision acuity was assessed with the use of Sivtsev-Golovin's and Orlova's tables and by visocontrastometry in a blind test. Common visometry has shown a reliable and approximately similar improvement of the vision acuity in Groups 2 and 3 patients, whereas visocontrastometry has not detected any changes of visual function in all the 3 groups. These results cast doubt on the true efficacy of He-Ne laser stimulation of visual function, at least in children, and once again demonstrate that such investigations may be carried out only with a reliable ('blind') control and placebo.
