D NIB (Decitabine) is a chemotherapy drug belonging to the class of hypomethylating agents. It is primarily used for treating myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Decitabine works by inhibiting DNA methylation, which can reactivate genes responsible for normal cell growth and differentiation.
Uses
Myelodysplastic Syndromes (MDS):
- Used in the treatment of patients with MDS, including refractory anemia, chronic myelomonocytic leukemia (CMML), and other related conditions.
Acute Myeloid Leukemia (AML):
- Effective in treating newly diagnosed AML, especially in older patients who are not candidates for intensive chemotherapy.
Decitabine incorporates into the DNA during replication and inhibits DNA methyltransferases. This leads to hypomethylation of DNA, allowing re-expression of tumor-suppressor genes and inhibiting the proliferation of cancer cells.
Side Effects
Common side effects include:
- Fatigue
- Nausea and vomiting
- Low blood counts (anemia, neutropenia, thrombocytopenia)
- Fever and infection
- Constipation
Serious side effects:
- Severe infections due to immunosuppression
- Bleeding disorders
- Liver function abnormalities
Precautions
Blood Count Monitoring:
- Regular monitoring of blood counts is necessary to manage side effects.
Pregnancy:
- Not recommended during pregnancy; can harm the fetus.
Liver and Kidney Function:
- Dose adjustments may be required based on organ function.
Infection Risk:
- Patients should take precautions to avoid infections.
Cardiac History:
- Patients with a history of heart disease should inform their healthcare provider.
Dosages
Myelodysplastic Syndromes (MDS):
- 15 mg/m² intravenously over 3 hours every 8 hours for 3 consecutive days, repeated every 6 weeks.
Acute Myeloid Leukemia (AML):
- 20 mg/m² intravenously daily for 5 consecutive days in a 4-week cycle.
Note: Dose adjustments may be needed based on side effects or organ function.
Storage
- Store at 2°C to 8°C (refrigerator).
- Protect from light and moisture.
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