Vitamin K2 therapy for a patient with myelodysplastic syndrome

Apoptosis/differentiation-inducing effects of vitamin K2 on HL-60 cells: dichotomous nature of vitamin K2 in leukemia cells

“…1 Therefore, it is not so surprising that these vitamin K compounds show some anti-leukemic activity. However, unlike these anti-tumor reagents, VK2 has a much lower toxicity and does not induce bone marrow suppression, [13][14][15]30 which are important clinical benefits for the treatment of patients with MDS and AML. Considerable evidence shows that mitochondria play a central role in apoptosis (reviewed in Ref.…”

“…In the patients with RAEB-T and post-MDS AML, VK2 has been reported to show a selective apoptosis induction of leukemic blasts cells in vitro, 17 to eliminate blastic cells and furthermore to improve cytopenia in vivo when the patients orally received 45 to 90 mg/day of MK4. 12, 13 Since hematological improvements were achieved without significant marrow suppression in some cases, the differentiation induction of the MDS clone in response to VK2 might also be involved. In addition, in a patient with RA, daily oral treatment of 45 mg of MK4 resulted in dramatic improvement of cytopenia, followed by becoming completely transfusion independent.…”

“…[13][14][15] In patients with MDS of refractory anemia of excess of blasts in transformation (RAEB-T) and post-MDS AML (a secondary AML arising from MDS), 16 VK2 has been reported to have an effect in the reduction of blast cell numbers and improvement of cytopenia without any adverse effects. 13,14 These data appear to be consistent with our in vitro observations showing that VK2 selectively induces apoptosis of blastic populations in the bone marrow cells of patients with refractory anemia of excess of blasts (RAEB), RAEB-T and AML. 17 However, VK2 therapy has also been reported to show the improvement of cytopenias in patients with refractory anemias (RA).…”

True

“…Clinical case reports demonstrating the efficacy of VK2 therapy for patients with MDS are already accumulating. 17,34 The novel cell line will be a useful tool for further studies of the molecular mechanism by which VK2 induces apoptosis. Information obtained with this novel cell line may provide important data for the clinical practice of VK2 therapy in the treatment of patients with MDS.…”

“…16 Oral administration of VK2 (MK4) to a patient with MDS and myelofibrosis resulted in a reduction of the number of peripheral leukemic blast cells and hematological improvement of anemia and thrombocytopenia without any toxicity. 17 Furthermore, oral daily administration of VK2 to leukemia bearing mice demonstrated significantly prolonged survival as compared to untreated leukemic mice (Miyazawa K, personal observation). These lines of evidence suggest a positive therapeutic benefit of using non-toxic VK2 for the treatment of MDS patients.…”