Tamoxifen: Hope for Blood Disease Patients

by Pearl Therese Aton

It was examinations week for Nina*, a 3rd-year Education student, and the questions weren’t the only things that surprised her. She has been feeling weak and dizzy in the days prior to the examinations week. During her exam, she was sitting in her chair, ready to answer her test paper when she felt a sharp pain in her chest. Nina felt dizzy and black spots started to block her vision. “Exam to namo sa English then nikalit lang dayon ko ug ka-lipong. Sakit kaayo akong dughan then nag-labad akong ulo,” Nina recalled. She was rushed to the clinic by her proctor and four of her friends. The next thing she knew, she woke up in white room and saw her mother sitting beside her. She was then covered in a thin white sheet of blanket and attached to her left arm was a thin plastic tube connected to a bottle of dextrose. Nina was already experiencing early signs of anemia.

Kristille, a 4th-year Accountancy student in a prominent university, has also been dealing with anemia ever since she was still a child. “I suspected that I have anemia because of my very pale complexion. When I had myself checked, my lab results would, most of the time, show that my red blood cells count is lower than normal,” she shared. Kristille usually sleeps late and tends to be stressed most of the time, which are minor causes of iron-deficiency anemia.

Anemia, as defined by Medicinenet.com, is the condition of having less than the normal number of red blood cells. There are many types of anemia. Nina and Kristille are suffering from iron-deficiency anemia. Since they have low iron in their system, the body doesn’t produce enough hemoglobin, a part of the red blood cells that carries oxygenated blood throughout the body. Doctors usually advise iron-deficiency anemics to eat iron-rich food or take iron pills. A blood transfusion is also a solution but only when it is needed.

Blood diseases like anemia and leukemia is a global problem. According to World Life Expectancy, leukemia ranks number 40 (266,820 deaths worldwide) on the recent list of the world’s causes of deaths while anemia ranks number 54 (102,571 deaths worldwide). In a 2004 report published in RightDiagnosis.com, an estimated number of 86,241,697 Filipinos are suffering from anemia. According to Department of Health’s 2010 health statistics, in a population of 100,000 aged 15 to 19 years old, 0.7% is anemic. The report further states that 2.9% of the total 2010 Filipino population is suffering from leukemia, regardless of the gender.

The global numbers on these blood diseases are disturbing, which is why there are now more efforts to raise awareness on these diseases. Blood transfusion and chemotherapy are two medical procedures that help in prolonging the life span of people suffering from severe blood diseases, but these procedures are not absolute cures.

Recently, Dr. Simón Méndez-Ferrer of Centro Nacional de Investigaciones Cardiovasculare – a research institute in Spain, together with his partners from Jürg Schwaller and Radek Skoda of the University Hospital in Basel, Switzerland, conducted a study on the effectiveness of Tamoxifen. It is a widely used drug for the treatment of breast cancer and has recently showed potentiality in blocking the development of a specific group of blood disorders known as myeloproliferative neoplasms.

According to the National Cancer Institute, a myeloproliferative neoplasm is a type of disease in which the bone marrow makes too many red blood cells, platelets, or certain white blood cells. It usually worsens over time as the number of extra cells builds up in the blood. This may cause anemia, fatigue, or other signs and symptoms. Certain myeloproliferative neoplasms may become acute myeloid leukemia (AML).

Dr. Mendez-Ferrer and his team’s study stated that excessive blood cells (or myeloproliferative neoplasm) can be destroyed by female sex hormones such as estrogen. The approved drug, tamoxifen–whose chemical structure resembles female sex hormones, can be used to block the development of blood neoplasms.

In the press release published in Eureka Alert, it stated that tamoxifen had very distinct effects depending on whether the test subject was healthy or sick. When the drug was administered to a healthy test subject, the drug caused the death of multipotent progenitors (a type of hematopoietic stem cells that have lost their self-renewal capacity but remain multipotent), and accelerated the stem cell division. But when tamoxifen was administered to a sick test subject, it imitated the function of a female sex hormone. Therefore, the test showed that the symptoms of the sick test subject disappeared and the progression of blood diseases were blocked.

"The fact that tamoxifen is already approved for clinical use and has an appropriate safety profile enormously increases the chances of these results leading to a clinical trial to test this potential therapy in patients with myeloproliferative neoplasms." Dr. Mendez-Ferrer and his team said in conclusion to the press release.

Nina and Kristille both shared positive opinions towards the research. “I think this will do good sa mga ga-suffer ug blood-related diseases such as anemia, pareha sa akoa,” Nina said. “I hope this drug can be easily accessed, especially the poor,” she added.

As of recently, Tamoxifen is being sold exclusively to patients who have been prescribed by their doctors to consume the said drug. With further researches and studies, this drug will soon be the answer to people suffering from blood diseases.

Sources:

World Life Expectancy

(http://www.worldlifeexpectancy.com/)

Definition of Anemia

(http://www.medicinenet.com/script/main/art.asp?articlekey=15492)

The 2010 Philippine Health Statistics

(http://www.doh.gov.ph/sites/default/files/PHS2010_March13.pdf)

Myeloproliferative Neoplasms - National Cancer Institute

(http://www.cancer.gov/cancertopics/types/myeloproliferative)

Hematopoietic multipotent progenitor (MPP)

(http://stemcellcommons.org/taxonomy/term/122)

Female sex hormones can protect against the development of some blood disorders