The U.S. Food and Drug Administration has approved two hypomethylating agents (HMAs), azacitidine and decitabine, for the treatment of chronic myelomonocytic leukemia (CMML), a rare and aggressive myeloid malignancy with overlapping features of myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN).1,2 Despite being widely used for MDS, there is a lack of strong clinical evidence supporting the use of these agents in patients with CMML, and outcomes can be variable between patients.
In this edition of “Drawing First Blood,” Ioannis Kotsianidis, MD, of Democritus University of Thrace in Greece, and Mrinal M. Patnaik, MBBS, of Mayo Clinic in Rochester, Minnesota, debate the evidence, or lack thereof, supporting the use of azacitidine and decitabine in CMML and whether these agents should be used, as options are limited. Dr. Kotsianidis was asked to argue in favor of HMAs and Dr. Patnaik was asked to argue against.
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