Medical Information

Azacitidine tablets, as demethylating drugs, require special attention to dosing regimen, efficacy monitoring, and adverse reaction management in the treatment of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). The following will explain from three aspects: indication verification, treatment plan optimization, and medication for special populations.

1. Indication verification

(1) MDS treatment needs to meet the diagnosis of IPSS intermediate risk -2 or high-risk group. (2) AML is suitable for elderly patients (≥ 75 years old) who are not suitable for intensive therapy. (3) Before treatment, the proportion of primitive cells needs to be confirmed through bone marrow biopsy.

2. Optimization of treatment plan

(1) Standard protocol: Subcutaneous injection of 75mg/m ², once daily for 7 days, with a 28 day cycle. (2) Oral preparations should be taken on an empty stomach (1 hour before or 2 hours after meals). (3) The evaluation of treatment response needs to last for 4-6 cycles.

3. Key points for efficacy monitoring

(1) Perform weekly pre cycle blood count testing. (2) Bone marrow assessment is conducted every 3 cycles. (3) Improvement in transfusion dependence as a secondary endpoint.

4. Management of special populations

(1) Renal insufficiency: Reduce by 50% when creatinine clearance rate is less than 30mL/min. (2) Liver dysfunction: Child Pugh C grade is contraindicated. (3) Elderly patients need to strengthen fall prevention.

5. Adverse reaction response

(1) Bone marrow suppression: Delayed administration when neutrophils<0.5 × 10 ⁹/L. (2) Gastrointestinal reactions: Prophylactic use of 5-HT3 antagonists. (3) Injection site reaction: rotate injection sites.