Maitake Mushroom Extract in Myelodysplastic Syndromes (MDS): A Phase II Study

Cancer Immunol Immunother. 2015 Feb;64(2):237-47. doi: 10.1007/s00262-014-1628-6. Epub 2014 Oct 29.

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 Escherichia coli, 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.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Biomarkers / blood
  • Biomarkers / metabolism
  • Bone Marrow / pathology
  • Bone Marrow Cells / metabolism
  • Case-Control Studies
  • Complex Mixtures / administration & dosage
  • Complex Mixtures / adverse effects
  • Complex Mixtures / therapeutic use*
  • Female
  • Grifola / chemistry*
  • Humans
  • Karyotype
  • Male
  • Middle Aged
  • Monocytes / immunology
  • Monocytes / metabolism
  • Myelodysplastic Syndromes / diagnosis
  • Myelodysplastic Syndromes / drug therapy*
  • Neutrophils / immunology
  • Neutrophils / metabolism
  • Reactive Oxygen Species / metabolism
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Biomarkers
  • Complex Mixtures
  • Reactive Oxygen Species