Autoimmunity may play a role in myelodysplasia for some patients, and immunosuppression in these patients may be beneficial. Saunthararajah et al developed a model for identifying patients with MDS likely to respond to immunosuppression. The authors are from the University of Illinois at Chicago and the National Heart, Lung, and Blood Institute at NIH.
Parameters:
(1) HLA-DR15 status
(2) age
(3) duration that the patient has been red blood cell transfusion dependent, in months
sum of age and duration of transfusion dependency =
= (age in years) + (months of being transfusion dependent)
HLA-DR15 Status
Sum of Age and Duration
Probability of Responding to Immunosuppression
negative
<= 57
high
negative
> 57
low
positive
<= 71
high
positive
> 71
low
where:
• A low probability of response ranges from 0 to 40%
• A high probability of response ranges from 41 to 100%.
Immunosuppression options:
(1) infusion of antithyrmocyte globulin (ATG)
(2) cyclosporine.
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