Glucocorticoids (GCs) are known for their clinically useful effects on immunologic and inflammatory disorders. Although there is a huge volume of knowledge concerning the cellular and molecular effects of GCs, clear statements regarding their effect in multiple diseases  in variable doses  are not crystal clear due to pharmacogenetic differences.

In our clinic, megadose methyl prednisolone (MDMP) have been successfully used for different hematological diseases, such as leukemias, bone marrow failure in aplastic anemia, hypoplastic anemia, myelodysplastic syndrome, neutropenia, autoimmune diseases and in some congenital hereditary diseases. Both clinical and experimental studies in our department revealed that MDMP was more effective than conventional dose steroids. The main effects of GCs in hematological disorders have been related to its differentiation and apoptosis  inducing effects in addition to modification of several steps of the hematopoietic and/or immune pathway have been reported. It is interesting that MDMP can be curative in some congenital hereditary diseases such as Diamond-Blackfan (D-B) syndrome. However  more research  is required to clarify their roles in biology, physiology and molecular genetics .