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Case Report: Acute Urinary Retention After Decitabine Treatment for AML

By: Emily Rhode
Posted: Friday, September 24, 2021

A 74-year-old female patient with adverse-risk acute myeloid leukemia (AML) presented with urinary retention after undergoing treatment with the hypomethylating agent decitabine, according to a recent case report published in Hematology, Transfusion and Cell Therapy. Although acute urinary retention is a rare symptom in women and is mainly caused by bladder outlet obstruction, Nelson Hamerschlak, MD, PhD, and colleagues, of the Hospital Israelita Albert Einstein, São Paulo, Brazil, could find not find any explanation for the symptom other than the use of decitabine.

The patient’s performance status precluded her from undergoing intensive chemotherapy. Instead, a therapeutic regimen of 20 mg/m2 decitabine and 400 mg/day with daily dose escalation of venetoclax was administered for 10 days. During this time, the patient also received platelet and blood transfusions and several prophylactic medications. On day 11 of the decitabine infusion, the patient presented with urinary retention accompanied by intestinal constipation. An indwelling urinary catheter was inserted, and laxatives were administered.

There was no change in renal function, nor were there any abnormal findings upon urinary investigation. The patient’s medical history revealed no surgery, trauma, or disorders that caused the urinary retention. No pelvic organ prolapses were found. Four days after a 28-day cycle of decitabine treatment, the patient again exhibited urinary retention and intestinal constipation. AML therapy was switched to azacitidine associated with venetoclax. No new episodes of urinary retention were reported.

The authors recommend future studies to investigate the potential association of decitabine with urinary retention. “Adverse reactions can be fatal for an elderly person undergoing treatment for AML,” they wrote. They emphasized the need for clinicians to be aware of the possibility of urinary retention during treatment with decitabine.

Disclosure: The study authors reported no conflicts of interest.



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