Decitabine

Information about Decitabine

Decitabine is a cytosine analogue and an intravenously administered antineoplastic agent used in the therapy of myelodysplastic syndromes. 

Liver safety of Decitabine

Decitabine is associated with a low rate of transient serum enzyme elevations during therapy, but has not been implicated in causing clinically apparent liver injury with jaundice.

Mechanism of action of Decitabine

Decitabine (dee sye' ta been) is a pyrimidine analogue (5-aza-deoxy-cytidine) which is the deoxyribose form of 5-azacitidine.  Decitabine is converted intracellularly to a triphosphate which becomes incorporated into DNA and appears to inhibit DNA methylation, resulting in increased expression of silenced genes including tumor suppressor genes.  Studies done in vitro and in vivo have shown that decitabine induces differentiation of bone marrow cells and results in normalization of bone marrow in a proportion of patients with myelodysplasia. 

FDA approval information for Decitabine

Decitabine was approved for use in the United States in 2006 and the current single indication is for therapy of myelodysplasic syndromes. 

Dosage and administration for Decitabine

Decitabine is available as a powder or solution for injection in 50 mg vials under the trade name of Dacogen.  The usual dosage regimen in adults is 15 to 20 mg per meter-squared body surface area given intravenously in several day regimens, with repeat cycles every 4 or 6 weeks.  A minimum of 4 courses is recommended. 

Side effects of Decitabine

Common side effects include bone marrow suppression, nausea, vomiting, diarrhea, stomatitis, bruising, abdominal pain, myalgias, headache, dizziness, fatigue, fever, rash and pruritus.

 

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