A hypomethylating chemotherapy for myelodysplastic syndromes and acute myeloid leukaemia
Decitabine
A chemotherapy medicine used to treat certain bone-marrow cancers, including acute myeloid leukaemia and myelodysplastic syndromes.
What is Decitabine?
Decitabine is a specialist chemotherapy used to treat certain bone-marrow cancers, mainly acute myeloid leukaemia and myelodysplastic syndromes. It is a hypomethylating agent, which means it switches certain genes back on inside cancer cells so they can mature or die rather than multiply. It is given in cycles, traditionally through a vein, and a newer tablet form combined with cedazuridine is also used. Its main risk is lowering blood cell counts, which raises the chance of serious infections, bleeding and tiredness, so blood is checked regularly throughout treatment.
Education and reference only. This is a plain-language guide to Decitabine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Decitabine is a chemotherapy medicine used to treat cancers of the bone marrow, particularly acute myeloid leukaemia and myelodysplastic syndromes, which are conditions where the marrow makes faulty or immature blood cells. It belongs to a group called hypomethylating agents. It is given in repeated cycles, usually as an infusion into a vein, and there is also an oral form combined with cedazuridine that protects it from being broken down in the gut. It is prescribed and supervised by a specialist cancer team, and treatment continues as long as it keeps helping.
How it works
In many cancer cells, helpful genes that would normally control growth are switched off by a chemical tag called methylation. Decitabine removes this tag, allowing those genes to work again, which encourages the faulty marrow cells to mature properly or to die instead of multiplying out of control. Because it acts on cells as they divide, it is given over several days in repeated cycles to keep affecting the cancer over time. The same action also affects healthy marrow, which is why blood cell counts often fall during treatment and need close monitoring.
Company & origin
Originated / developed by: Specialist manufacturers.
A specialist chemotherapy used in the UK to treat certain bone-marrow cancers, particularly acute myeloid leukaemia and myelodysplastic syndromes.
Practical use
How to take Decitabine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Have it as your specialist team arranges, given in repeated cycles either through a vein or, for the tablet form, by mouth as directed.
- If you take the oral form, follow the timing around food exactly as instructed and swallow it whole without crushing or chewing.
- Attend all blood-test and treatment appointments, as counts decide whether each cycle goes ahead.
- Report any fever, sore throat, chills or other signs of infection straight away, as these can be serious during treatment.
- Use reliable contraception during treatment and for the time afterwards that your team advises, and report any possible pregnancy promptly.
Weighing it up
Advantages & disadvantages of Decitabine
Advantages
- An effective treatment option for acute myeloid leukaemia and myelodysplastic syndromes, including in people who cannot have intensive chemotherapy.
- Works in a targeted way by switching helpful genes back on rather than only killing dividing cells.
- Available as an infusion and, combined with cedazuridine, as a tablet that can be taken at home.
Disadvantages
- Lowers healthy blood cell counts, raising the risk of serious infections, bleeding and tiredness.
- Given in repeated cycles with frequent blood tests and appointments.
- Can cause nausea, tiredness and other chemotherapy side effects, and can harm an unborn baby.
Practical use
Good to know
The most important thing to understand about decitabine is that it lowers the levels of healthy blood cells made by the bone marrow, which is its main risk. Low white cells make serious infections more likely, low platelets raise the risk of bruising and bleeding, and low red cells cause tiredness and breathlessness, so any fever, signs of infection or unusual bleeding need urgent medical attention. Blood counts are checked regularly and treatment may be delayed or adjusted depending on the results. Nausea, tiredness and a higher chance of infection are common, and supportive treatments such as anti-sickness medicines or transfusions are often used alongside it. Because it is chemotherapy, it can harm an unborn baby, so reliable contraception is important during treatment and for a time afterwards for both women and men, and it is given only under specialist supervision.
Who should not take it / use with caution
- People who have had a serious allergic reaction to decitabine should not have it.
- It is not used in pregnancy or while breastfeeding, as it can harm an unborn baby.
- It is used with particular care in people with low blood counts, serious infections or liver or kidney problems, under specialist judgement.
Monitoring
- Regular blood counts before and during each cycle to guide treatment and watch for low cells.
- Checking for signs of infection, bleeding or anaemia throughout treatment.
- Reviewing liver and kidney function and overall response to treatment over time.
Side effects
- Low blood cell counts, leading to a higher risk of serious infections, bleeding, bruising and tiredness.
- Nausea, vomiting, diarrhoea or constipation, often managed with supportive medicines.
- Fever, headache or reactions where an infusion is given.
- Rarely but seriously, severe or life-threatening infections or bleeding, which need urgent medical care.
Key interactions
- Other medicines or treatments that lower blood counts can add to the effect, so they are combined carefully.
- Live vaccines are generally avoided during treatment because the immune system is weakened.
- Tell your team about all your medicines, including anything bought over the counter, before and during treatment.
Available as: A powder made up into a solution for infusion into a vein, and a tablet combined with cedazuridine taken by mouth.
Answers
Decitabine: frequently asked questions
What is decitabine used for?
It is a chemotherapy used to treat certain bone-marrow cancers, mainly acute myeloid leukaemia and myelodysplastic syndromes, by helping faulty marrow cells mature or die rather than multiply.
Why does it need so many blood tests?
Decitabine lowers healthy blood cell counts, so regular blood tests check your levels and decide whether each cycle can safely go ahead.
Why am I more likely to get infections?
It lowers white blood cells that fight infection, so any fever or signs of infection need urgent medical attention while you are being treated.
Is there a tablet version?
Yes, there is an oral form combined with cedazuridine, which protects decitabine so it can work when taken by mouth; follow the timing around food exactly.
Do I need contraception?
Yes. Because it is chemotherapy and can harm an unborn baby, reliable contraception is important during treatment and for a time afterwards for both women and men.
The wider class
About Hypomethylating agent (chemotherapy for blood cancers)
Decitabine belongs to the hypomethylating agent (chemotherapy for blood cancers) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF
- NICE CKS
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