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Safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome

The goals of treating older patients with myelodysplastic syndrome (MDS) are different than for younger patients. Few elderly patients are able to pursue an allogeneic stem cell transplant for potential cure of the disease. The focus for the treatment of older patients with MDS is therefore not cura...

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Autor principal: Ritchie, Ellen K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393359/
https://www.ncbi.nlm.nih.gov/pubmed/22791989
http://dx.doi.org/10.2147/CIA.S24659
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author Ritchie, Ellen K
author_facet Ritchie, Ellen K
author_sort Ritchie, Ellen K
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description The goals of treating older patients with myelodysplastic syndrome (MDS) are different than for younger patients. Few elderly patients are able to pursue an allogeneic stem cell transplant for potential cure of the disease. The focus for the treatment of older patients with MDS is therefore not curative, but rather alleviation of symptoms, improvement in quality of life, maintenance or improvement of functional status, and continued independent living. Prolongation of survival is only important if functional status and quality of life can be maintained, and there is greater risk of losing these outcomes in elderly patients. Azacitidine is an important drug for the treatment of older patients with MDS. Data from the AZA-001 trial has shown a survival benefit for patients with high-risk disease treated with azacitidine. Importantly, treatment has also been shown to improve quality of life for MDS patients. Subset analysis of the data has shown that the drug can be used safely in even the oldest patients with MDS and is superior to treatment with other established regimens, such as low-dose cytarabine. Given the delay between the initiation of treatment and the clinical response, patients may need aggressive supportive care with antiemetics, prophylactic antibiotics, and transfusions to maintain them through therapy. Azacitidine provides a better quality of response when it is used beyond the first response, so ongoing treatment is generally recommended in responding patients. A new oral preparation of the drug is in development that will make the treatment more feasible and comfortable for elderly patients.
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spelling pubmed-33933592012-07-12 Safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome Ritchie, Ellen K Clin Interv Aging Review The goals of treating older patients with myelodysplastic syndrome (MDS) are different than for younger patients. Few elderly patients are able to pursue an allogeneic stem cell transplant for potential cure of the disease. The focus for the treatment of older patients with MDS is therefore not curative, but rather alleviation of symptoms, improvement in quality of life, maintenance or improvement of functional status, and continued independent living. Prolongation of survival is only important if functional status and quality of life can be maintained, and there is greater risk of losing these outcomes in elderly patients. Azacitidine is an important drug for the treatment of older patients with MDS. Data from the AZA-001 trial has shown a survival benefit for patients with high-risk disease treated with azacitidine. Importantly, treatment has also been shown to improve quality of life for MDS patients. Subset analysis of the data has shown that the drug can be used safely in even the oldest patients with MDS and is superior to treatment with other established regimens, such as low-dose cytarabine. Given the delay between the initiation of treatment and the clinical response, patients may need aggressive supportive care with antiemetics, prophylactic antibiotics, and transfusions to maintain them through therapy. Azacitidine provides a better quality of response when it is used beyond the first response, so ongoing treatment is generally recommended in responding patients. A new oral preparation of the drug is in development that will make the treatment more feasible and comfortable for elderly patients. Dove Medical Press 2012 2012-06-19 /pmc/articles/PMC3393359/ /pubmed/22791989 http://dx.doi.org/10.2147/CIA.S24659 Text en © 2012 Ritchie, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Review
Ritchie, Ellen K
Safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome
title Safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome
title_full Safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome
title_fullStr Safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome
title_full_unstemmed Safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome
title_short Safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome
title_sort safety and efficacy of azacitidine in the treatment of elderly patients with myelodysplastic syndrome
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393359/
https://www.ncbi.nlm.nih.gov/pubmed/22791989
http://dx.doi.org/10.2147/CIA.S24659
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