Maitake mushroom extract in myelodysplastic syndromes (MDS): A phase II study Journal Article
| Authors: | Wesa, K. M.; Cunningham Rundles, S.; Klimek, V. M.; Vertosick, E.; Coleton, M. I.; Yeung, K. S.; Lin, H.; Nimer, S.; Cassileth, B. R. |
| Article Title: | Maitake mushroom extract in myelodysplastic syndromes (MDS): A phase II study |
| Abstract: | Background: Myelodysplastic syndromes (MDS) are characterized by ineffective erythropoiesis with dysplastic bone marrow leading to peripheral cytopenia, risk of infection, and progression to acute myelogenous leukemia. Maitake mushroom beta-glucan, a dietary supplement, stimulates hematopoietic progenitor cell differentiation, granulocyte colony-stimulating factor production, and recovery of peripheral blood leukocytes after bone marrow injury. This phase II trial examined the effects of Maitake on innate immune function in MDS. Methods: Myelodysplastic syndromes patients with International Prognostic Scoring System Low- and Intermediate-1-risk disease received oral Maitake extract at 3 mg/kg twice daily for 12 weeks. Primary endpoints included neutrophil count and function tested as endogenous or stimulated neutrophil production of reactive oxygen species (ROS) by flow cytometry compared with age-matched healthy controls (HC). ROS activators were Escherichiacoli, phorbol ester, and the bacterial peptide N-formylmethionyl-leucyl-phenylalanine (fMLP). Complete blood counts, chemistry panels, iron studies, and monocyte function were evaluated. Results: Of 21 patients enrolled, 18 completed the study and were evaluable. Maitake increased endogenous (basal) neutrophil (p = 0.005) and monocyte function (p = 0.021). Pre-treatment monocyte response to E. coli was reduced in MDS patients compared with HC (p = 0.002) and increased (p = 0.0004) after treatment. fMLP-stimulated ROS production response also increased (p = 0.03). Asymptomatic eosinophilia occurred in 4 patients (p = 0.014). Other changes in albumin, hemoglobin, and total protein were not clinically relevant. Conclusions: Maitake was well tolerated. Enhanced in vitro neutrophil and monocyte function following treatment demonstrate that Maitake has beneficial immunomodulatory potential in MDS. Further study is warranted. |
| Keywords: | adult; clinical article; controlled study; aged; unclassified drug; acute granulocytic leukemia; chronic myelomonocytic leukemia; diarrhea; drug efficacy; drug safety; drug withdrawal; flow cytometry; controlled clinical trial; neutrophil count; phase 2 clinical trial; leukopenia; nausea; hemoglobin; albumin; myelodysplastic syndrome; neutrophil; reactive oxygen metabolite; innate immunity; open study; monocyte; maitake; grifola frondosa; lymphocyte count; beta-glucan; eosinophil count; eosinophilia; fungal extract; infections; formylmethionylleucylphenylalanine; international prognostic scoring system; human; male; female; priority journal; article; maitake mushroom extract |
| Journal Title: | Cancer Immunology, Immunotherapy |
| Volume: | 64 |
| Issue: | 2 |
| ISSN: | 0340-7004 |
| Publisher: | Springer |
| Date Published: | 2015-02-01 |
| Start Page: | 237 |
| End Page: | 247 |
| Language: | English |
| DOI: | 10.1007/s00262-014-1628-6 |
| PROVIDER: | scopus |
| PMCID: | PMC4317517 |
| PUBMED: | 25351719 |
| DOI/URL: | |
| Notes: | Export Date: 2 March 2015 -- Source: Scopus |
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