Efficacy of decitabine as hemoglobin F inducer in HbE/β-thalassemia
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To study safety, efficacy (hemoglobin and hemoglobin F percentage increment in non-transfusion-dependent patients and decrease in transfusion frequency in transfusion-dependent patients), and determinants of response of decitabine in patients with HbE/β-thalassemia. Thirty patients of HbE/β-thalassemia (age > 18 years) were enrolled. Both transfusion-dependent (TDT) and non-transfusion-dependent (NTDT) patients were included after obtaining informed consent. Participants received 0.2 mg/kg of 5-aza-2′-deoxycytidine (decitabine) subcutaneously on 2 consecutive days a week for at least 12 weeks. Complete hemogram was done every 2 weeks and HPLC at every 4-week interval, until 2 months after last dose of drug for response assessment. Various factors like XMN1 polymorphism, IVS 1-5, alpha deletion, alpha triplication, baseline hemoglobin F, and baseline total hemoglobin were evaluated as determinants of response. Mean therapy period was 20.32 weeks. For NTDT group, peak mean increment in hemoglobin was 0.938 g/dl (p value < .001) and hemoglobin F percentage was 9.62% (p value < .001). Transfusion requirement decreased to 0.25 units compared to 0.96 units per patient per month for TDT patients over a period of last 1 year. Common side effects were respiratory tract infection (grade I/II) in three patients, chest tightness in one patient (grade I), and gastric erosion (grade III) in one patient. Decitabine is safe and efficacious in HbE/β-thalassemia.
KeywordsDecitabine HbE/β-thalassemia Hemoglobin F induction
State Thalassemia Unit, IHTM, Kolkata
Compliance with ethical standards
Ethical Clearance: Yes, from institutional ethical committee.
Consent Taken: Yes, from all the participants in the study.
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Taher A, Vichinsky E, Musallam K, Cappellini MD, Viprakasit V (2013) Guidelines for the management of non-transfusion dependent thalassaemia (NTDT). Thalassaemia International Federation, NicosiaGoogle Scholar
- 4.Bravo M, Salazar R, Arends A, Alvarez M, Velazquez D, Guevara JM, Castillo O (1999) Detection of beta thalassemia by the technique of refractory amplification of mutation systems (ARMS-PCR). Investig Clin 40(3):203–213Google Scholar
- 5.Bhagat S, Patra PK, Thakur AS (2012) Association between XmnI polymorphism and HbF level in sickle cell disease patients from Chhattisgarh. Int J Biomed Sci 1:36–39Google Scholar
- 9.Rigano P, Pecoraro A, Calzolari R, Troia A, Acuto S, Renda D, Pantalone GR, Maggio A, Di Marzo R (2010) Desensitization to hydroxycarbamide following long-term treatment of thalassaemia intermedia as observed in vivo and in primary erythroid cultures from treated patients. Br J Haematol 151(5):509–515CrossRefPubMedGoogle Scholar
- 12.Wang W, Ma ES, ,Chan AY, Prior J, Erber WN, Chan LC, Chui DH, Chong SS. Single-tube multiplex-PCR screen for anti-3.7 and anti-4.2 α-globin gene triplications. Clin Chem 49(10):1679–82Google Scholar