Slides from a presentation at ASH 2008 and transcribed comments from recent interviews with David P Steensma, MD (12/18/08) and Gail J Roboz, MD (10/6/09) below

DAVID P STEENSMA, MD: Decitabine is another agent that is trying to enter the elderly AML clinical scenario. This paper examined five-day decitabine as front-line therapy for patients who are “unfit or unsuitable” for induction therapy. The study had 55 patients over age 60 with newly diagnosed AML. About half of the patients had de novo disease. The study demonstrated an overall response rate of 26 percent and the median time to the best response was about three months.

GAIL J ROBOZ, MD: This paper is important because decitabine has been thought of as a drug for the treatment of myelodysplastic syndromes (MDS). However, the data describing the use of this drug in acute myelogenous leukemia (AML) appear to be even more promising. The use of decitabine is moving forward in the cooperative group setting as a possible front-line strategy for older patients with AML. The community should be aware of these data and not think of decitabine as a drug for the treatment of MDS only.

Dr Steensma is Attending Physician at Dana-Farber Cancer Institute and Associate Professor of Medicine at Harvard Medical School in Boston, Massachusetts.

Dr Roboz is Associate Professor of Medicine and Director of the Leukemia Program at Weill Medical College of Cornell University at NewYork-Presbyterian Hospital in New York, New York.