Azacitidine for the Treatment of Myelodysplastic Syndromes, Chronic Myelomonocytic Leukaemia and Acute Myeloid Leukaemia (TA218)

Technology Appraisal Guidance No. 218

Source: National Institute for Health and Care Excellence

1. Guidance

1.1 Azacitidine is recommended as a treatment option for adults who are not eligible for haematopoietic stem cell transplantation and have:

  • intermediate-2 and high-risk myelodysplastic syndromes according to the International Prognostic Scoring System (IPSS) or
  • chronic myelomonocytic leukaemia with 10–29% marrow blasts without myeloproliferative disorder or
  • acute myeloid leukaemia with 20–30% blasts and multilineage dysplasia, according to the World Health Organization classification
  • if the manufacturer provides azacitidine with the discount agreed as part of the patient access scheme.

The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at

An abridged version of this guidance (a 'quick reference guide') is also available. Printed copies of the quick reference guide can be obtained by contacting 0845 003 7783 or emailing and quoting reference number N2491. It is also available on the Internet at

This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

© Copyright National Institute for Health and Care Excellence. All rights reserved. This material may be freely reproduced for educational and not for profit purposes within the NHS. No reproduction by or for commercial organisations is permitted without the express written permission of the Institute.

Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email:

Azacitidine for the Treatment of Myelodysplastic Syndromes, Chronic Myelomonocytic Leukaemia and Acute Myeloid Leukaemia
Issue Date: March 2011
Review Date: February 2014

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