Post transplant Vidaza

[mausmish]

At the recommendation of my transplant doctor at Johns Hopkins, i'm going to start Vidaza treatments on post transplant day+90 for one year. The purpose of the treatments is to help prevent a relapse. There is a formal study to assess efficacy pending that has not begun yet. Is anyone else here familiar with this treatment?

[Birgitta-A]

Hi Karen,
I can’t find any studies about Vidaza in patients after SCT without relapse. My doctor has written his thesis about Vidaza in MDS.

In the 4th paper (page 43) “Complex effects of azacitidine in primary myelodysplastic and normal bone marrow cell cultures” he reports that they assessed the effect of azacitidine on bone marrow cell growth and colony formation.

“Interestingly, azacitidine in doses up to 5 μM did not affect cell growth or viability in the suspension cultures. Actually, the absolute number of cells per ml was higher in azacitidine treated positions than in controls in 1/10 normal bone marrow and in 4/10 MDS. Neither was there any inhibitory effect on colony formation after exposure to azacitidine in doses up to 0.5 μM for 24 hours. In fact, the number of colonies (especially erythroid colonies) increased by >70% with the lower doses of azacitidine in 5/9 evaluable MDS and 5/13 normal bone marrow.”
http://publications.ki.se/jspui/bitstream/10616/40311/1/My%20thesis.pdf
Kind regards
Birgitta-A

[mausmish]

Thanks, Birgitta! That was a very interesting paper, although I won't claim to understand all the details. I was pleased to see one of the conclusions on page 47:

"Azacitidine, also in high doses, has limited toxicity on normal bone marrow progenitors. In fact, clonogenic assays suggest a possible direct stimulatory effect of azacitidine on bone marrow progenitors. This supports the use of azacitidine maintenance after allogeneic stem cell transplantation to reduce the risk of relapse."

Karen

[Birgitta-A]

Hi Karen,
I don't understand all the details but - like you - I understand the conclusions: Vidaza doesn't seem to be toxic to the young red blood cells and can perhaps increase them. The WBCs and the platelets will perhaps decrease but it can be better to give a drug early before the malignant cells have been too many and you really have a relapse.
Kind regards
Birgitta-A