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.
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.
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Authors: Hagop Kantarjian; Jean-Pierre J Issa; Craig S Rosenfeld; John M Bennett; Maher Albitar; John DiPersio; Virginia Klimek; James Slack; Carlos de Castro; Farhad Ravandi; Richard Helmer; Lanlan Shen; Stephen D Nimer; Richard Leavitt; Azra Raza; Hussain Saba Journal: Cancer Date: 2006-04-15 Impact factor: 6.860
Authors: Matteo Molica; Carla Mazzone; Pasquale Niscola; Ida Carmosino; Ambra Di Veroli; Cinzia De Gregoris; Fabrizio Bonanni; Salvatore Perrone; Natalia Cenfra; Luana Fianchi; Anna Lina Piccioni; Antonio Spadea; Giovanni Luzi; Andrea Mengarelli; Laura Cudillo; Luca Maurillo; Livio Pagano; Massimo Breccia; Luigi Rigacci; Paolo De Fabritiis Journal: Cancers (Basel) Date: 2022-10-06 Impact factor: 6.575