How it is administered

Decitabine is administered as an intravenous (IV) infusion. It is supplied as a sterile, white to off-white lyophilized powder in single-dose vials, which must be reconstituted and diluted before use. There are two main dosing regimens:

• Three Day Regimen: 15 mg/m² by continuous IV infusion over 3 hours, every 8 hours for 3 days, repeated every 6 weeks.
• Five Day Regimen: 20 mg/m² by continuous IV infusion over 1 hour, once daily for 5 days, repeated every 4 weeks.

Your healthcare provider will determine the most appropriate regimen and will monitor your blood counts and organ function before and during treatment.

How it works

Decitabine is a nucleoside metabolic inhibitor. It works by incorporating into the DNA of rapidly dividing cells, such as cancer cells, after being phosphorylated. Once inside the DNA, decitabine inhibits an enzyme called DNA methyltransferase. This inhibition leads to hypomethylation of DNA, which can restore normal function to genes that control cell differentiation and growth. In cancer cells, this can result in the reactivation of tumor suppressor genes and promote cell death (apoptosis) or the return of cells to a more normal state (differentiation).

Because decitabine mainly affects rapidly dividing cells, it is particularly useful in treating blood cancers like myelodysplastic syndromes (MDS), where abnormal cells divide uncontrollably. Non-dividing cells are less affected by decitabine, which helps target the treatment to cancerous cells.

Who Should take it

Decitabine is indicated for adult patients with myelodysplastic syndromes (MDS). This includes patients who have previously been treated or untreated, those with de novo (newly diagnosed) or secondary MDS, and all French-American-British subtypes (such as refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia). It is also suitable for patients in intermediate-1, intermediate-2, and high-risk groups according to the International Prognostic Scoring System (IPSS).

Your doctor may recommend decitabine if you have MDS and need treatment to improve blood counts, reduce transfusion needs, or slow disease progression. It may also be considered for some patients with acute myeloid leukemia (AML) if other options are not suitable.

Who should not take it

There are no absolute contraindications listed for decitabine. However, you should not take decitabine if you are allergic to it or any of its components.

Decitabine can cause harm to an unborn baby. It should not be used during pregnancy unless clearly needed, and effective contraception is recommended for women of childbearing potential during treatment and for 6 months after the last dose. Men with female partners of reproductive potential should use contraception during treatment and for 3 months after the last dose. Breastfeeding is not recommended during treatment and for at least 2 weeks after the last dose.

Patients with severe infections, significant liver or kidney impairment, or those who are not able to tolerate myelosuppression (low blood counts) should discuss risks and benefits with their healthcare provider.

Commonly used with

Decitabine is sometimes used with supportive care measures such as blood transfusions, antibiotics, and hematopoietic growth factors (like G-CSF) to manage low blood counts and reduce infection risk.

It may also be used as part of a treatment plan that includes other medications for blood cancers, depending on your specific diagnosis and response to therapy.

Commonly tested with

Decitabine has been tested in combination with supportive care (such as transfusions and antibiotics) in clinical trials for myelodysplastic syndromes (MDS).

It is also studied alongside other hypomethylating agents and in combination with new investigational drugs for blood cancers. Your doctor may recommend decitabine alone or as part of a clinical trial with other treatments.