decitabine (Dacogen)

A demethylating agent, this drug interacts with DNA to restore normal growth of blood cells in the bone marrow. It works by reducing the amount of methylation in the body. Methylation is a process that acts like a switch to turn off or “silence” genes in certain cells. When these genes (called tumor suppressor genes) are turned off, MDS cells and cancer cells can grow freely. Decitabine is approved by the U.S. Food and Drug Administration (FDA) for treating all MDS subtypes, though it is used most commonly to treat higher-risk MDS.