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 language | English (US) |
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Pages (from-to) | 205-210 |
Number of pages | 6 |
Journal | Clinical Lymphoma, Myeloma and Leukemia |
Volume | 10 |
Issue number | 3 |
DOIs | |
State | Published - Jun 2010 |
Externally published | Yes |
Keywords
- Azacitidine
- Decitabine
- Myelodysplastic syndrome
- Serum creatinine
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research