Azacitidine is used for the treatment of acute myeloid leukemia and chronic myelomonocytic leukemia. This is a type of chemotherapy medicine used to treat cancer known as a cytotoxic antimetabolite. The Food and Drug Administration (FDA) has already approved this prescription.

Acute myeloid leukemia begins in the bonemarrow, but most often it quickly moves into the blood as well. It cansometimes spread to other parts of the body including the testicles, lymphnodes, spleen, liver, central nervous system. Most often, this conditiondevelops from cells that would turn into white blood cells m but sometimes itdevelops in other types of blood-forming cells.

Bone marrow is the soft inner part ofcertain bones. It is made up of blood-forming cells, fat cells, and supportingtissues. A small fraction of the blood-forming cells is blood stem cells.

Signs and symptoms of acute myeloid leukemia include:

   •    Pale skin

    •    Fever

   •    Bone pain

   •    Shortness of breath

    •    Frequent infections

   •    Lethargy and fatigue

   •    Easy bruising

   •    Unusual bleeding such asfrequent nosebleeds and bleeding from the gums

Acute myeloid leukemia is caused by damageto the DNA of developing cells in your bone marrow. When this happens, bloodcell production goes wrong. The bone marrow produces immature cells thatdevelop into leukemic white blood cells called myeloblasts. These abnormalcells are unable to function properly and they can build up and crowd outhealthy cells.

Chronic myelomonocytic leukemia occurswhen monocytes in the bone marrow begin to grow out of control. Wherein, itfills the bone marrow and preventing other blood cells from growing. The exactcause of this condition is not known. However, there are known risk factorsthat increase the chances of getting this condition. They include:

   •    Older age

   •    Past treatment with certainanticancer drugs

   •    Being male

   •    Being exposed to radiation

   •    Being exposed to certainchemicals at work or in the environment

The most common sign of chronicmyelomonocytic leukemia is having too many monocytes which are a type of whiteblood cell in the blood. These cells can settle in the liver and spleen thatcauses them to enlarge. They can also cause the bone marrow to make less ofother blood cells that may result in:

   •    A low number of bloodplatelets

   •    A low number of normal whiteblood cells that can lead to a fever and frequent or severe infections

   •    A low number of red bloodcells that can lead to pale skin, feeling very tired, shortness of breath

How does Azacitidine work?

The bone marrow creates cells called stemcells. These usually develop into the different types of blood cells. Whenthese are mature, they leave the bone marrow and enter the bloodstream.

In leukemia, the bone marrow createsexcessive immature white blood cells. These abnormal cells take up space in thebone marrow and result in less room for the production of normal healthy bloodcells. In another group of disorders that affect the bone marrow and bloodcells, the bone marrow doesn’t create enough normal healthy blood cells. It mayalso produce too many immature blood cells. Azacitidine treats these conditionsby stopping the abnormal blood cells from multiplying. It does this byinhibiting the production of the cells’ genetic material DNA and RNA. Both DNAand RNA are needed for growth and multiplication of cells. This medicationcauses a deficiency of DNA and RNA in the abnormal cells and causes the cellsto grow in an unbalanced way. In which it results in the death of the cells.

Unfortunately, Azacitidine can also affecthealthy and normal cells particularly those that multiply quickly. The mostimportant side effect is on the bone marrow where blood cells are made. Thisdrug can also temporarily lessen the production of healthy blood cells whichleaves people susceptible to infection. Therefore, regulations blood tests areneeded to monitor the levels of blood cells.

How to use Azacitidine?

This medication is given by injectionunder the skin or into a vein by a doctor. If you are receiving the injectionunder the skin your doctor will change the injection site each time. It is tolessen injury under the skin.

This medication is injected usually once aday for 7 days in a row or as directed by your doctor. A 7-day course of thismedication is called a cycle. This cycle is repeated every 4 weeks depending onyour response and blood tests. The dosage is based on your medical condition,lab tests, body size, and response to treatment.

What are the side effects of Azacitidine?

Common side effects:

   •    Tiredness

   •    Weakness

   •    Headache

   •    Diarrhea

   •    Anxiety

   •    Dizziness

   •    Insomnia or trouble sleeping

   •    Constipation or stomach pain,

   •    Vomiting

   •    Nausea

   •    Loss of appetite

   •    Joint or muscle pain

   •    Cold symptoms such as sorethroat, sneezing or stuffy nose

   •    Injection site reactions(irritation, redness, pain, or bruising)

Tell your doctor if you have serious sideeffects of this drug including:

    •    Chest pain

   •    Easy bleeding or bruising

   •    Irregular heartbeat

   •    Muscle cramps

   •    Swollen ankles or feet

   •    mental/mood changes (anxietyor depression)

   •    Dark urine

   •    Changes in the amount ofurine

   •    Yellowing eyes or skin

Warnings and Precautions

    •    This medicine can lessen the number of healthy blood cells in your blood. For this reason, you will need regular blood tests to monitor your blood cells during treatment with this medicine.

    •    This drug may be harmful to an unborn baby. For this reason, you should use effective contraception to avoid getting pregnant during treatment. You should continue to use contraception to prevent pregnancy for at least three months after treatment. Discuss this with your doctor. Women should consult their doctor right away if they get pregnant during treatment.

   •    Your ability to becomepregnant or father a child may be affected by this medicine. It is important todiscuss fertility with your doctor before starting treatment.

   •    Use this drug carefully inpeople with decreased liver or kidney function, with low numbers of white bloodcells in their blood, or with heart or lung disease.

   •    This is not recommended foruse in people with advanced liver cancer.

    •    Let your doctor know if you have ever had an allergic reaction to this drug. Tell as well if you have any allergies. This product may contain ingredients that can cause an allergic reaction.