The Results Of Prednisone Treatment For Myelofibrosis-Associated Anemia

Objective:To observe the clinical effects of prednisone treatment in patients with myelofibrosis-associated anemia.Methods:A cohort of fourteen myelofibrosis with anemia patients were studied in the period from 10/2011 to 10/2016 at our institution.Patients were administered oral prednisone,at an initial dose of 0.7–1 mg/kg daily(media 0.8 mg/kg daily).The drug dosage was gradually tapered down to the minimum effective dose(5-10 mg daily)as maintenance therapy after three months in responding patients,whereas treatment was discontinued in non-responders according to the modified criteria of the International Working Group in 2013.During treatment,adverse effects were recorded.Results : Fourteen myelofibrosis patients(11 men,3 women)consisted of eleven primary myelofibrosis and three post-ET myelofibrosis.The media age were 54.5 years(range 24-78years).There were 66.67%(8/12)patients belonged to high-risk categories according to the IPSS/DIPSS.The longest time from diagnosis to treatment was 12 year,35.7%(5/14)were more than one year.Six patients had prior history of other traditional treatments.Initial median hemoglobin was 61g/L(range 42-90g/L).Ten patients(71.43%)achieved anemia response after a median time of 12(3-49)months on treatment.Median duration of treatment and anemia response was 6.5 weeks(range 2-12 weeks)and 5.5 months(range 3-36 months).Six of seven initially RBC transfusion-dependent patients became transfusion independent following the therapy.Nonhematologic side-effects of clinical relevance included one case of hyperglycemia and one case of peripheral neuropathy.Hematological toxicity was not found.Three patients died of infection and one died of liver failure caused of hepatitis B while on prednisone treatment.Conclusions:Higher –dose of prednisone can improve the anemia of MF,especially in selected older MF patients after failure to standard therapies.