Next Article in Journal
Role of Factor H and Related Proteins in Regulating Complement Activation in the Macula, and Relevance to Age-Related Macular Degeneration
Next Article in Special Issue
Pediatric AML: From Biology to Clinical Management
Previous Article in Journal
The Insulin-Like Growth Factor System in Obesity, Insulin Resistance and Type 2 Diabetes Mellitus
Previous Article in Special Issue
Targeted Therapy of FLT3 in Treatment of AML—Current Status and Future Directions
Article Menu

Export Article

Open AccessReview
J. Clin. Med. 2015, 4(1), 1-17; doi:10.3390/jcm4010001

Clinical Results of Hypomethylating Agents in AML Treatment

1
Department of Hematology, Radboud University Medical Center, PO Box 9191, 6500 HB Nijmegen, The Netherlands
2
Department of Medicine, University of Freiburg Medical Center, D-79106, Freiburg, Germany
3
Department of Hematology, Haga Hospital, 2545 CH, The Hague, The Netherlands
*
Author to whom correspondence should be addressed.
Academic Editor: Celalettin Ustun
Received: 18 September 2014 / Accepted: 2 December 2014 / Published: 25 December 2014
(This article belongs to the Special Issue AML in the Molecular Age: From Biology to Clinical Management)
View Full-Text   |   Download PDF [197 KB, uploaded 25 December 2014]   |  

Abstract

Epigenetic changes play an important role in the development of acute myeloid leukemia (AML). Unlike gene mutations, epigenetic changes are potentially reversible, which makes them attractive for therapeutic intervention. Agents that affect epigenetics are the DNA methyltransferase inhibitors, azacitidine and decitabine. Because of their relatively mild side effects, azacitidine and decitabine are particularly feasible for the treatment of older patients and patients with co-morbidities. Both drugs have remarkable activity against AML blasts with unfavorable cytogenetic characteristics. Recent phase 3 trials have shown the superiority of azacitidine and decitabine compared with conventional care for older AML patients (not eligible for intensive treatment). Results of treatment with modifications of the standard azacitidine (seven days 75 mg/m2 SC; every four weeks) and decitabine (five days 20 mg/m2 IV; every four weeks) schedules have been reported. Particularly, the results of the 10-day decitabine schedule are promising, revealing complete remission (CR) rates around 45% (CR + CRi (i.e., CR with incomplete blood count recovery) around 64%) almost comparable with intensive chemotherapy. Application of hypomethylating agents to control AML at the cost of minimal toxicity is a very promising strategy to “bridge” older patients with co-morbidities to the potential curative treatment of allogeneic hematopoietic cell transplantation. In this article, we discuss the role of DNA methyltransferase inhibitors in AML. View Full-Text
Keywords: AML; azacitidine; decitabine; hypomethylating agents; elderly; epigenetics AML; azacitidine; decitabine; hypomethylating agents; elderly; epigenetics
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Cruijsen, M.; Lübbert, M.; Wijermans, P.; Huls, G. Clinical Results of Hypomethylating Agents in AML Treatment. J. Clin. Med. 2015, 4, 1-17.

Show more citation formats Show less citations formats

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top