P1-21-3 - A Hemodialysis Patient with Myelodysplastic Syndrome Treated with Azacitidine

Abstract

Background: Azacitidine is one of the agents of DNA methyltransferase inhibitor available for the treatment of myelodysplastic syndrome (MDS) patients. But its safety for renal failure and dialysis patients is not established.A case report: An 80-year-old patient was seen in May 2013 at our Department of Hematology for anemia and leucopenia. He needed maintenance dialysis for chronic kidney disease, stage G5D. His hemoglobin level was 5.5 g/dl, and bone marrow aspiration was carried out; then he was diagnosed with MDS. Cytogenetic analysis revealed a normal karyotype, and he was classified as low-risk group by the Revised International Prognostic Scoring System (IPSS-R). At first, he was treated with red-cell transfusions, but frequent transfusions were necessary, so he was then treated with standard-dose azacitidine. There were no adverse events in particular. Although he underwent four overall courses of azacitidine treatment, no hematological improvement was seen, so the treatment was discontinued.Discussion: There is little recent study of patients with renal insufficiency receiving treatment with hypomethylating agents for hematological malignancies. We were able to give azacitidine to a dialysis patient safely, but unfortunately no effect was found.