title: A comparison of toxicities in acute myeloid leukemia patients with and without renal impairment treated with decitabine.
abstract: Purpose There are limited data regarding the clinical use of decitabine for the treatment of acute myeloid leukemia in patients with a serum creatinine of 2 mg/dL or greater. Methods We retrospectively evaluated 111 patients with acute myeloid leukemia who had been treated with decitabine and compared the development of toxicities during cycle 1 in those with normal renal function (creatinine clearance greater than or equal to 60 mL/min) to those with renal dysfunction (creatinine clearance less than 60 mL/min). Results Notable differences in the incidence of grade ≥3 cardiotoxicity (33% of renal dysfunction patients vs. 16% of normal renal function patients, p = 0.042) and respiratory toxicity (40% of renal dysfunction patients vs. 14% of normal renal function patients, p = 0.0037) were observed. The majority of heart failure, myocardial infarction, and atrial fibrillation cases occurred in the renal dysfunction group. The odds of developing grade ≥3 cardiotoxicity did not differ significantly between patients with and without baseline cardiac comorbidities (OR 1.43, p = 0.43). Conclusions This study noted a higher incidence of grade ≥3 cardiac and respiratory toxicities in decitabine-treated acute myeloid leukemia patients with renal dysfunction compared to normal renal function. This may prompt closer monitoring, regardless of baseline cardiac comorbidities. Further evaluation of decitabine in patients with renal dysfunction is needed.
authors.affiliation: 1 Department of Pharmacy, The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, OH, USA.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Levine
authors.affiliation: 1 Department of Pharmacy, The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, OH, USA.
authors.forename: Julianna Vf
authors.initials: JV
authors.lastname: Roddy
authors.affiliation: 1 Department of Pharmacy, The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, OH, USA.
authors.forename: Miryoung
authors.initials: M
authors.lastname: Kim
authors.affiliation: 2 College of Pharmacy, The Ohio State University, Columbus, OH, USA.
authors.forename: Junan
authors.initials: J
authors.lastname: Li
authors.affiliation: 3 Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Phillips
authors.affiliation: 4 Department of Internal Medicine, Division of Hematology, The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, OH, USA.
authors.forename: Alison R
authors.initials: AR
authors.lastname: Walker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D001374:Azacitidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D015331:Cohort Studies; D015897:Comorbidity; D000077209:Decitabine; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D000077209:Decitabine; D001374:Azacitidine
keywords: Decitabine; acute myeloid leukemia; renal impairment; toxicity