Advances in Therapy

, Volume 28, Supplement 4, pp 1–5

Adverse effects of azacitidine: Onset, duration, and treatment

Review

Abstract

High-risk myelodysplastic syndromes present a poor prognosis, with survivals of close to only 1 year. The use of azacitidine, a DNA methyltransferase inhibitor, in this group of patients has transformed this grey image, with a demonstrated improvement in survival. Responses to survival are attained in a progressive manner, providing that the drug is used continually. This requires a good control of the adverse effects of the drug, which are primarily in the first cycles of treatment. The hematological adverse effects can be handled with transfusions and growth factors. The nonhematological adverse effects can be prevented with the use of antiemetics and a good technique of drug administration.

Keywords

adverse effects azacitidine myelodysplastic syndromes 

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References

  1. 1.
    Valent P, Horny HP, Bennet JM, et al. Definitions and standards in the diagnosis and treatment of the myelodysplastic syndromes: consensus statements and report from a working conference. Leuk Res. 2007;31:72–36.CrossRefGoogle Scholar
  2. 2.
    Greenberg P, Cox C, LeBeau MM, et al. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood. 1997;89:2079–2098.PubMedGoogle Scholar
  3. 3.
    Anderson JE, Appelbaunm FR, Fisher LD, et al. Allogeneic bone marrow transplantation for 93 patients with myelodysplastic syndromes. Blood. 1993;82:677–683.PubMedGoogle Scholar
  4. 4.
    Martino R, Iacobelli S, Brand R, et al. Retrospective comparison of reduced-intensity conditioning and conventional high-dose conditioning for allogeneic hematopoietic stem cell transplantation using HLA-identical sibling donors in myelodysplastic syndromes. Blood. 2006;108:836–846.PubMedCrossRefGoogle Scholar
  5. 5.
    Silverman LR, Demakos EP, Peterson BL, et al. Randomized controlled trial of azacitidine in patients with the myelodysplastic syndrome: a study of the Cancer and Leukemia Group B. J Clin Oncol. 2002;20:2429–2440.PubMedCrossRefGoogle Scholar
  6. 6.
    Fenaux P, Mufti GJ, Hellstrom-Linndberg E, et al. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodisplastic syndromes: a randomized, open-label, phase III study. Lancet Oncol. 2009;10:223–232.PubMedCrossRefGoogle Scholar
  7. 7.
    Silverman LR, Fenaux P, Mufti GJ, et al. The effects of continued azacitidine (AZA) treatment cycles on response in higher-risk patients with myelodysplastic syndromes. Blood. 2008;112:227. Abstract 227.Google Scholar
  8. 8.
    Lyons RM, Cosgriff TM, Modi SS, et al. Hematologic response to three alternative dosing schedules of azacitidine in patients with myelodisplastic syndromes. J Clin Oncol. 2009;27:1850–1856PubMedCrossRefGoogle Scholar
  9. 9.
    Ross SD, Allen E, Probst CA, et al. Efficacy and safety of erythropoiesis-stimulating proteins in myelodysplastic syndrome: a systematic review and meta-analysis. Oncologist. 2007;12:1264–1273.PubMedCrossRefGoogle Scholar
  10. 10.
    Moyo V, Lefebvre P, Duh MS, et al. Erythropoiesis-stimulating agents in the treatment of anemia in myelodisplastic syndromes: a meta-analysis. Ann Hematol. 2008;87:527–536.PubMedCrossRefGoogle Scholar
  11. 11.
    Fenaux P, Bowen D, Gattermann N, et al. Practical use of azacitidine in higher-risk myelodisplastic syndromes: an expert panel opinion. Leuk Res. 2010;34:1410–1416.PubMedCrossRefGoogle Scholar
  12. 12.
    Vidaza® (azacitidine injection) [product information].Celgene Europe Ltd. Boudry, Switzerland; 2008.Google Scholar
  13. 13.
    Bassy GN, Kantarjian H, Issa JP, et al. Feasibility of therapy with hypomethylating agents in patients with renal insufficiency. Clin Lymphoma Myeloma Leuk. 2010;10:205–210.CrossRefGoogle Scholar
  14. 14.
    Platzbecker U, Aul C, Ehninger G, et al. Reduction of 5-azacitidine induced skin reactions in MDS patients with evening primrose oil. Ann Hematol. 2010;89:427–428.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Healthcare 2011

Authors and Affiliations

  1. 1.Department of HematologyHospital Universitario Santa María del RosellCartagenaSpain

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