Georgescu Daniela 1, Popescu M. 1, Tevet M. 1, Patrinoiu O. 1, Murat M. 1, Popov V. 1, Dragan C. 1, Balea M. 1, Ciuhu A. 2
1 Hematology, Colentina Hospital, Bucharest, Romania
2 Oncology, Saint Luke Hospital, Bucharest, Romania
Abstract
The hypomethylating agents such as azacitidine (AZA) and decitabine, have received FDA approval for the treatment of myelodysplastic syndrome (MDS) and chronic myelo- monocytic leukemia (CMML )[1]. The clinical studies demonstrated that treatment with hypomethilating agents (5-azacytidine and decitabine) in intermediate/high risk MDS resulted in complete responses in some cases. Also for patients with acute myeloid leukemia (AML) who do not qualify for aggressive chemotherapy and allogeneic medullary transplantation, treatment with hypomethilating agents leads to transfusional independence and increase in quality of life. We present the evolution under treatment with hypomethilating agents in 13 patients, diagnosed with intermediate/high risk MDS and AML in our Department between 2009-2014. There were 7 men and 6 women, with ages between 56-84 years, 6 of them diagnosed with intermediate 1 and 2 risk MDS, and 7 diagnosed with AML, unfit for chemotherapy. The selected schedules were: 5-Aza 75 mg/m2/d, for 7 days, repeated every 28 days and Decitabine 20mg/m2/d, for 5 days, repeated every 28 days. Results: All patients had a good tolerance to therapy, without significant adverse events. The overall response to 5-Aza was heterogeneous, with no considerable differences regarding blast percentage, with one complete response in the case with 12 monosomy. Unfortunately in 3 patients with AML treated with Decitabine, there was a delay in the time of treatment initiation due to administrative and financial issues, and they died due to disease progression. There were no side effects. The presented data indicate similar results to those in literature. The most important effect of treatment was increase in the quality of life by the reduction in the transfusional demand.