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Question

1.A 74-year-old woman was treated with azacitidine (aka, 5-aza-cytidine) for her intermediate-risk myelodysplastic syndrome. She was treated at 75 mg/m2 daily for 7 days via subcutaneous injection. You see her 1 week after completion of her last dose. She is surprised that her anemia is not improved. What do you tell the patient?

A. Switching to decitabine is indicated

B. Evaluation of myeloid mutation panel is warranted to investigate resistance mutations

C. Subcutaneous infection is inferior to intravenous injection

D. Patients should be treated for a minimum of 4 to 6 cycles. Complete or partial response may require additional treatment cycles