Department of Hematologic Malignancies, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA.
Hematol Oncol Clin North Am. 2010 Apr;24(2):389-406. doi: 10.1016/j.hoc.2010.02.012.
Clinicians commonly administer one or the other of the two hypomethylating agents currently approved in the United States--azacitidine or decitabine--to patients with aggressive forms of myelodysplastic syndromes (MDS). However, there continues to be uncertainty about the optimal choice of agent, the best initial dose and treatment schedule, the role of hypomethylating agents in patients with more indolent disease, the most appropriate management of treatment-associated adverse events, and the most desirable approach to maintain responses. The evidence base supporting clinical decisions around these questions varies widely in depth and quality. This article discusses practical considerations for clinicians who use hypomethylating agents to treat patients with MDS.
临床医生通常会给患有侵袭性骨髓增生异常综合征 (MDS) 的患者使用美国目前批准的两种去甲基化药物中的一种或另一种——阿扎胞苷或地西他滨。然而，对于哪种药物是最佳选择、最佳初始剂量和治疗方案、去甲基化药物在惰性疾病患者中的作用、治疗相关不良事件的最佳管理以及维持反应的最理想方法等问题，仍然存在不确定性。支持这些问题临床决策的证据基础在深度和质量上差异很大。本文讨论了临床医生在使用去甲基化药物治疗 MDS 患者时的实际考虑因素。
