Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study

Kathleen M. Wesa, Susanna Cunningham-Rundles, Virginia M. Klimek, Emily Vertosick, Marci I. Coleton, K. Simon Yeung, Hong Lin, Stephen D Nimer, Barrie R. Cassileth

Research output: Contribution to journalArticle

14 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)237-247
Number of pages11
JournalCancer Immunology, Immunotherapy
Volume64
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Grifola
Agaricales
Myelodysplastic Syndromes
Monocytes
Neutrophils
N-Formylmethionine Leucyl-Phenylalanine
Reactive Oxygen Species
Bone Marrow
beta-Glucans
Blood Cell Count
Erythropoiesis
Eosinophilia
Phorbol Esters
Granulocyte Colony-Stimulating Factor
Dietary Supplements
Hematopoietic Stem Cells
Acute Myeloid Leukemia
Cell Differentiation
Albumins
Flow Cytometry

Keywords

  • Beta-glucan
  • Infections
  • Maitake
  • Monocyte
  • Myelodysplastic syndrome
  • Neutrophil

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Immunology
  • Immunology and Allergy

Cite this

Wesa, K. M., Cunningham-Rundles, S., Klimek, V. M., Vertosick, E., Coleton, M. I., Yeung, K. S., ... Cassileth, B. R. (2014). Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study. Cancer Immunology, Immunotherapy, 64(2), 237-247. https://doi.org/10.1007/s00262-014-1628-6

Maitake mushroom extract in myelodysplastic syndromes (MDS) : a phase II study. / Wesa, Kathleen M.; Cunningham-Rundles, Susanna; Klimek, Virginia M.; Vertosick, Emily; Coleton, Marci I.; Yeung, K. Simon; Lin, Hong; Nimer, Stephen D; Cassileth, Barrie R.

In: Cancer Immunology, Immunotherapy, Vol. 64, No. 2, 2014, p. 237-247.

Research output: Contribution to journalArticle

Wesa, KM, Cunningham-Rundles, S, Klimek, VM, Vertosick, E, Coleton, MI, Yeung, KS, Lin, H, Nimer, SD & Cassileth, BR 2014, 'Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study', Cancer Immunology, Immunotherapy, vol. 64, no. 2, pp. 237-247. https://doi.org/10.1007/s00262-014-1628-6
Wesa KM, Cunningham-Rundles S, Klimek VM, Vertosick E, Coleton MI, Yeung KS et al. Maitake mushroom extract in myelodysplastic syndromes (MDS): a phase II study. Cancer Immunology, Immunotherapy. 2014;64(2):237-247. https://doi.org/10.1007/s00262-014-1628-6
Wesa, Kathleen M. ; Cunningham-Rundles, Susanna ; Klimek, Virginia M. ; Vertosick, Emily ; Coleton, Marci I. ; Yeung, K. Simon ; Lin, Hong ; Nimer, Stephen D ; Cassileth, Barrie R. / Maitake mushroom extract in myelodysplastic syndromes (MDS) : a phase II study. In: Cancer Immunology, Immunotherapy. 2014 ; Vol. 64, No. 2. pp. 237-247.
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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.",
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AU - Wesa, Kathleen M.

AU - Cunningham-Rundles, Susanna

AU - Klimek, Virginia M.

AU - Vertosick, Emily

AU - Coleton, Marci I.

AU - Yeung, K. Simon

AU - Lin, Hong

AU - Nimer, Stephen D

AU - Cassileth, Barrie R.

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N2 - 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.

AB - 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.

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