Background: Azacitidine is a nucleoside metabolic inhibitor for treating myelodysplastic syndrome (MDS). Chest pain was noted in 16% of patients treated with Azacitidine. However, this chest pain's exact mechanism of action remains to be elucidated. Azacitidine is a pyrimidine, similar to another nucleoside analog FU, a fluoropyrimidine. The tool of chest pain is likely similar for both drugs. We present a case of management of Azacitidine-related chest pain with a previously utilized protocol for FU-related chest pain with complete pain relief for the patient, which allowed continuation of therapy.
Case presentation:We present a novel case of a 63-year-old male with high-risk MDS progressing to acute myeloid leukemia (AML) on active treatment with Azacitidine who presents with angina. Successful treatment of his pain allowed for the continuation of chemotherapy.
Conclusion:To our knowledge, this is the first reported case of pretreatment with vasodilators for managing Azacitidine-associated chest pain.