Combination Therapy with Recombinant Human Erythropoietin and Granulocyte Colony-Stimulating Factor in Idiopathic Myelofibrosis

Abstract

Abstract : Myelobbrosis or fibrosis of the bone marrow is associated with a variety of diseases. This disorder may be primary or secondary disorder and a relatively common clinical hematological problem. A man, aged 54 years with proven myelotibrosis was reported. The clinical presentation was anemia, moderated or low grade fever and abdominal distension for several months: Extensive search was made without evidence of tuberculosis before first definite diagnosis of myelofibrosis. While he was suffering from many problem of intercurrent complication such as tuberculosis adenopathy, bilateral renal stone with gross hematuria and urinary tract infection, severe anema, granulocytopenia and severe thrombocytopenia : clinical response to combination therapy with recombinant human - erythropoietin (r-hu-Epo 50 U/kg, 3 times weekly for 1 month) to improve the anemia and platelet count and white blood cell count due to granulocyte-colony-stimulating factor (G-CSF, Filgrastim, 300 Lig daily for 7 days) was remarkable. Potentially important kinetic interaction have been documented for combination with r-hu-Epo, interferon-alpha-2b and GM-CSF, but not a combination of r-hu-Epo and G-CSF. This report is the fist that proven the combination is also very good response in idiopathic myelofibrosis.