Vidaza response, treatment between cycles

[veola]

Hello! I would greatly appreciate if anyone could help me to clarify some information on Vidaza treatment.
My mother, who lives in Ukraine, was diagnosed with a myelodysplastic syndrome, refractory anemia with excess of blasts in the last October. Since she is 72 years old, the bone marrow transplantation was out of question. She was started on low dose Cytarabine therapy but eventually this therapy failed.
A week ago she was started on Vidaza and by the end of the 7th day of treatment she still has blasts in her peripheral blood smear. The doctors there are not very experienced in using Vidaza and so I would greatly appreciate if anyone could help me answer the following questions:
1. Is this common to still have some blasts in the peripheral blood smear after the first cycle of Vidaza? Or is this considered a failure?
2. If this is not a failure then what should be done in terms of treatment in between cycles of Vidaza?
3. Is this common to achieve partial or complete response only after a few cycles of Vidaza treatment?
Once again, I would greatly appreciate your responses.

[Birgitta-A]

Hi Veola,
First I will try to answer your questions and then I post an article about Vidaza. That is probably too complicated for you - you know you could always google Vidaza and get some info from the drug company.

1. Yes, blast cells in blood are common after one cycle.
2. Supportive therapy like blood transfusions if needed, platelet transfusions if needed, Neupogen or similar drugs for low white blood cells if needed, antibiotics for infections. Often they wait a little with next cycle if the counts are very low.
3. A little more than 50 % of high risk patients improve on Vidaza and a little more than 60 % of low risk patients. The doctors often evaluate the result of treatment after 6 months but some patients respond later. It is not common with a good response after a few cycles.

http://bloodjournal.hematologylibrar...117/2/403.full

Hope your mothe will have a good response!
Kind regards
Birgitta-A
72 yo, dx MDS 2006, very severe bone marrow fibrosis, only supportive therapy with txs, Neupogen and drugs for iron overload till June 2010. Good response to Thalidomide + Prednisone with stable HGB about 13 and platelets about 100. Stopped taking Exjade July 2011 when my ferritin level was less than 1000.

[veola]

Thank you so much Birgitta. Thank you. I really appreciate it.

[julkonov]

My mother - 64 y - was diagnosed MDS RAEB2 in May 2011 ( 20% blast ), flow cytometry shows 12-13% blasts, cd45 - low to middle expression, cd11b/-+/, cd33/+/, cd36/+-/, cd117/+/, cd34/+/, HLA-DR /+/, CD71/+/
On 28.06.2011 she made a very big phlegmona of the abdominal wall ( withouth peritonitis) she received it from exercise ( due to overextension of the muscle, then lifting a heavy baggage and considering the disease - hypoplastic bone marrow...)
She was admitted on 22.06.2011 in hematology department with high temperature not able to slow down and a second bone marrow biopsy ( after they treated her in the hospital for 6 days with 3 types of antibiotics simultaneously) shows 65% blasts.So she is diagnosed AML right now and we should begin chemotherapy immediately - cytarabine and anthracycline.
I`d like to ask 1. Is it possible that the recent phlegmona, treated with powerful and 5 different types of antibiotics, and now once again 6 days on powerful antiboitcs - 3 types influenced the % of the blast?
2.Cytarabine or Vidaza for iduction is better?
The doctors here ( i`m writing from Bulgaria) don`t have experience with Vidaza.

Best regards,
Julia