title: Activity of decitabine in patients with myelodysplastic syndrome previously treated with azacitidine.
abstract: Azacitidine and decitabine are the two hypomethylating agents approved by the Food and Drug Administration for the treatment of patients with myelodysplastic syndrome (MDS). The efficacy of one agent post-failure of the other is unknown. Fourteen patients with MDS post-azacitidine failure/lack of response/intolerance were treated with decitabine. Overall three patients achieved a complete remission, and one patient had hematologic improvement, for an overall response rate of 28%. Of the responders, one stopped prior 5-azacitidine owing to disease progression, two for no response and one for severe skin toxicity. Grade 3-4 drug related side-effects were minimal. Global methylation studies in patient samples showed decrease of methylation after treatment with decitabine. As in our previous studies, there was no difference in hypomethylation between responders and nonresponders. We conclude that clinically significant responses with decitabine can be seen in patients post-azacitidine failure without significant toxicity.
authors.affiliation: Department of Leukemia, M. D. Anderson Cancer Center, Houston, TX 77030, USA. gborthak@mdanderson.org
authors.forename: Gautam
authors.initials: G
authors.lastname: Borthakur
authors.forename: Samih El
authors.initials: SE
authors.lastname: Ahdab
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ferrajoli
authors.forename: Beth
authors.initials: B
authors.lastname: Newman
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Issa
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001374:Azacitidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D019175:DNA Methylation / Q000187:drug effects; D000077209:Decitabine; D006801:Humans; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D016879:Salvage Therapy / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000077209:Decitabine; D001374:Azacitidine