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Azadine is an antineoplastic agent that works as a hypomethylating agent. It is primarily used in the treatment of certain types of myelodysplastic syndromes (MDS), a group of bone marrow disorders. Azadine helps restore normal gene function, promoting healthy blood cell production and inhibiting the growth of abnormal cells in the bone marrow.

Indications:

1. Myelodysplastic Syndromes (MDS):
   • Refractory anemia or anemia with excess blasts.
   • Chronic myelomonocytic leukemia (CMML).
   • Intermediate-2 and high-risk MDS based on the International Prognostic Scoring System (IPSS).
2. Acute Myeloid Leukemia (AML):
   • For patients with AML who are not candidates for intensive chemotherapy.

Azadine incorporates into DNA and RNA, inhibiting DNA methyltransferase. This results in hypomethylation of DNA and reactivation of silenced tumor suppressor genes. The drug also disrupts RNA processing, which may contribute to its anti-cancer effects. These mechanisms slow or stop the growth of abnormal cells and promote normal cell development.

Common Side Effects: Nausea and vomiting, Fatigue, Anemia, thrombocytopenia, and neutropenia, Injection site reactions (e.g., redness, pain), Diarrhea or constipation.

Serious Side Effects:

• Myelosuppression: Increased risk of infections and bleeding due to low blood cell counts.
• Renal Toxicity: Monitor renal function regularly.
• Hepatotoxicity: Liver enzyme elevation or hepatic failure in rare cases.

Monitoring Requirements:

• Complete blood counts (CBC) before and during treatment.
• Liver and kidney function tests.
• Signs of infections or bleeding.

Standard Dose:

• Subcutaneous or Intravenous Administration: 75 mg/m² body surface area daily for 7 consecutive days, repeated every 28 days.
• Duration: At least 4 to 6 cycles for optimal response.

Administration Tips:

• For subcutaneous injection, administer into the upper arm, thigh, or abdomen, rotating injection sites.
• For IV infusion, dilute and infuse over 10–40 minutes.