How do you choose between azacitidine and decitabine when deciding to treat a patient with MDS with a hypomethylating agent?

The only agent to prolong overall survival in patients with MDS is azacitidine so this is always my first choice particularly in older individuals at higher risk for complications of myelosuppression occurring at a higher rate with decitabine. Other issues to consider include ease of administration (subq versus intravenous) and need for continuous intravenous access for decitabine. This needs to be weighed against the 5 days versus 7 days of therapy. Because decitabine is more potent in terms of...