In Myelodysplastic syndrome, hypomethylating agents, 5-azacytidine and 5-aza-2'-deoxycytidine (decitabine), which work by inhibiting DNA methyltransferase, have been approved (MDS). Cytopenias, nausea, pain, and local reactions in injection sites are the most common side effects of hypomethylating agents. Toxicity associated with other organ functions is extremely uncommon. As the fourth case in the literature, our paper reported a case in which a decrease in left ventricular ejection fraction (EF) was observed as a result of Decitabine treatment due to no response to Azacitidine. In the literature, three cases of cardiac toxicity and function loss have been reported. Because our case did not have an ECHO before beginning Decitabine treatment after Azacitidine, it is unclear whether cardiac toxicity occurred with 10 cycles of Azacitidine or 1 cycle of Decitabine treatment. To understand the etiology and pathophysiology of this side effect, large patient series in randomized controlled trials are required.
Author (S) Details
Mehmet Can Ugur
Department of Hematology, Health Sciences University, Bozyaka Education and Training Hospital, Turkey.
Cansu Atmaca Mutlu
Hematology, Democracy University, Buca Seyfi Demirsoy Education and Training Hospital, Turkey.
Prof. Dr. Oktay Bilgir
Department of Hematology, Health Sciences University, Bozyaka Education and Training Hospital, Turkey.
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