Hypomethylating Agents in the Treatment of High-Risk MDS

Video

For High-Definition, Click

The treatment of patients with high-risk myelodysplastic syndrome (MDS) who do not appear to respond to hypomethylating agents is challenging, given a lack of effective treatment options. If a patient does not respond to treatment following 4 to 6 cycles of azacitidine or decitabine, evidence suggests it may be beneficial to continue treatment for 9 cycles, if the patient has stable disease, suggests Rami S. Komrokji, MD.

At this point, there are only a few approved treatment options for patients with high-risk MDS, notes Ruben A. Mesa, MD. As a result, progression or intolerance are the primary drivers for switching to an alternative therapy. For patients who progress on hypomethylating agents, the overall outcome is very poor with a median survival of around 4 months, adds Elias J. Jabbour, MD.

For patients with low-risk MDS, it may be appropriate to stop treatment with a hypomethylating agent if a response is not seen after 4 to 6 cycles. In this scenario, the goal is less focused on extending survival and more to control the number of transfusions, Komrokji states.

Related Videos
Lori A. Leslie, MD
Changchun Deng, MD, PhD
Guenther Koehne, MD, PhD
Ibrahim Aldoss, MD
D. Ross Camidge, MD, PhD
D. Ross Camidge, MD, PhD
D. Ross Camidge, MD, PhD
Andrew P. Jallouk, BS, MD, PhD, assistant professor, Vanderbilt University
Elias Jabbour, MD, professor, Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center
Manmeet Singh Ahluwalia, MD