Feasibility of therapy with hypomethylating agents in patients with renal insufficiency

G. Nicolas Batty, Hagop Kantarjian, Jean Pierre Issa, Elias Jabbour, Fabio P.S. Santos, Deborah McCue, Guillermo Garcia-Manero, Sherry Pierce, Susan O'Brien, Jorge E. Cortés, Farhad Ravandi

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background: To our knowledge, the feasibility of therapy with hypomethylating agents (HAs) in patients with renal insufficiency (RI) has not been examined. Patients and Methods: We reviewed 41 patients with a diagnosis of acute myeloid leukemia (n = 17), myelodysplastic syndromes (n = 15), and chronic myelomonocytic leukemia (n = 9) who had RI and were receiving therapy with azacitidine or decitabine. The median number of administered cycles was 3. Most patients (39; 95%) received a standard dose of the drugs at the initiation of therapy. Nine patients (22%) required treatment interruptions or discontinuation, and 10 patients (24%) required dose reductions. Results: The overall response rate was 63%, and 4 patients (10%) achieved a complete response. Twenty patients (51%) experienced grade 3 or 4 myelosuppression- related toxicities. Hospitalization was required in 68% of the patients. Among 12 patients with an estimated glomerular filtration rate of 29 mL per minute or less, 6 required dose reductions attributable to myelosuppression (n = 3) or to worsening renal function (n = 3). The overall survival (OS) at 18 months was 12%, and the median OS was 8.6 months. Conclusion: The use of HA in patients with RI is feasible, but is associated with a higher incidence of toxicity. Dose adjustments and the use of growth factor may be necessary for some patients.

Original languageEnglish (US)
Pages (from-to)205-210
Number of pages6
JournalClinical Lymphoma, Myeloma and Leukemia
Volume10
Issue number3
DOIs
StatePublished - Jun 2010

Keywords

  • Azacitidine
  • Decitabine
  • Myelodysplastic syndrome
  • Serum creatinine

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Batty, G. N., Kantarjian, H., Issa, J. P., Jabbour, E., Santos, F. P. S., McCue, D., Garcia-Manero, G., Pierce, S., O'Brien, S., Cortés, J. E., & Ravandi, F. (2010). Feasibility of therapy with hypomethylating agents in patients with renal insufficiency. Clinical Lymphoma, Myeloma and Leukemia, 10(3), 205-210. https://doi.org/10.3816/CLML.2010.n.032