Preventing Infections in Higher-Risk Myelodysplastic Syndrome Patients Treated with Hypomethylation Agents

Yishai Ofran

Department of Hematology and Bone Marrow Transplantation; Rambam Health Care Campus. Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel

Citation: EMJ Hema. 2013;1:58-63.

Abstract

Hypomethylation agents became the standard of care for patients with high-risk myelodysplastic syndrome (MDS). While long-term benefits of azacitidine (AZA) and decitabine (DEC) were demonstrated in multiple studies, methods to enhance patients’ safety during therapy with those agents are pending. The causative correlations between drug administration and non-life threatening complications such as injection-site erythema or gastrointestinal (GI) discomfort are obvious. However, infections, which are the most common life-threatening complication among higher risk MDS patients, are frequent even in those receiving therapy other than hypomethylation agents, including supportive care solely. Therefore, the contribution of hypomethylation therapy to infection risk is difficult to determine. Herein, data regarding infectious complications, their prevalence, risk stratification, and methods of prevention will be reviewed.

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