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 bone marrow, but most often it quickly moves into the blood as well. It can sometimes spread to other parts of the body including the testicles, lymph nodes, spleen, liver, central nervous system. Most often, this condition develops from cells that would turn into white blood cells m but sometimes it develops in other types of blood-forming cells.

Bone marrow is the soft inner part of certain bones. It is made up of blood-forming cells, fat cells, and supporting tissues. 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 as frequent nosebleeds and bleeding from the gums

Acute myeloid leukemia is caused by damage to the DNA of developing cells in your bone marrow. When this happens, blood cell production goes wrong. The bone marrow produces immature cells that develop into leukemic white blood cells called myeloblasts. These abnormal cells are unable to function properly and they can build up and crowd out healthy cells.

Chronic myelomonocytic leukemia occurs when monocytes in the bone marrow begin to grow out of control. Wherein, it fills the bone marrow and preventing other blood cells from growing. The exact cause of this condition is not known. However, there are known risk factors that increase the chances of getting this condition. They include:

    •    Older age

    •    Past treatment with certain anticancer drugs

    •    Being male

    •    Being exposed to radiation

    •    Being exposed to certain chemicals at work or in the environment

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

    •    A low number of blood platelets

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

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

How does Azacitidine work?

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

In leukemia, the bone marrow creates excessive immature white blood cells. These abnormal cells take up space in the bone marrow and result in less room for the production of normal healthy blood cells. In another group of disorders that affect the bone marrow and blood cells, the bone marrow doesn’t create enough normal healthy blood cells. It may also produce too many immature blood cells. Azacitidine treats these conditions by stopping the abnormal blood cells from multiplying. It does this by inhibiting the production of the cells’ genetic material DNA and RNA. Both DNA and RNA are needed for the growth and multiplication of cells. This medication causes a deficiency of DNA and RNA in the abnormal cells and causes the cells to grow in an unbalanced way. It results in the death of the cells.

Unfortunately, Azacitidine can also affect healthy and normal cells particularly those that multiply quickly. The most important side effect is on the bone marrow where blood cells are made. This drug can also temporarily lessen the production of healthy blood cells which leaves people susceptible to infection. Therefore, regulations blood tests are needed to monitor the levels of blood cells.

How to use Azacitidine?

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

This medication is injected usually once a day for 7 days in a row or as directed by your doctor. A 7-day course of this medication is called a cycle. This cycle is repeated every 4 weeks depending on your 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 sore throat, sneezing or stuffy nose

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

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

    •    Chest pain

    •    Easy bleeding or bruising

    •    Irregular heartbeat

    •    Muscle cramps

    •    Swollen ankles or feet

    •    mental/mood changes (anxiety or depression)

    •    Dark urine

    •    Changes in the amount of urine

    •    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 become pregnant or father a child may be affected by this medicine. It is important to discuss fertility with your doctor before starting treatment.

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

    •    This is not recommended for use 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.