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Case Reports
. 2024 Aug 8:22:100477.
doi: 10.1016/j.lrr.2024.100477. eCollection 2024.

Successful treatment of AML using non-intensive chemotherapy in Jehovah's Witness patients

David Page  1 , Daniel Sawler  1 , Joseph Brandwein  1
Affiliations
Case Reports

Successful treatment of AML using non-intensive chemotherapy in Jehovah's Witness patients

David Page et al. Leuk Res Rep. .

Abstract

Acute myeloid leukemia (AML) patients undergoing induction chemotherapy receive transfusion support to manage severe cytopenias and associated sequelae. Jehovah's Witness (JW) patients typically decline transfusion of most or all blood products. This can lead to exclusion of JW patients from otherwise life-saving treatments due to safety concerns. We present two cases demonstrating the successful induction of JW patients without the need for red cell or platelet transfusion support; the first, an older AML patient induced with azacitidine & venetoclax; the second, a patient with acute promyelocytic leukemia induced using arsenic trioxide and all-trans retinoic acid. Both patients required modifications to the induction regimens to accommodate their wishes. These cases support growing evidence that selected JW patients with AML can be successfully treated using appropriate accommodations.

Keywords: AML; Chemotherapy; Jehovah's Witness; Leukemia; Treatment.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Joseph Brandwein reports a relationship with AbbVie Inc that includes: board membership and consulting or advisory. Joseph Brandwein reports a relationship with Amgen Inc that includes: board membership and consulting or advisory. Joseph Brandwein reports a relationship with Astellas Pharma Inc that includes: board membership and consulting or advisory. Joseph Brandwein reports a relationship with Bristol Myers Squibb Co that includes: board membership and consulting or advisory. Joseph Brandwein reports a relationship with Jazz Pharmaceuticals Inc that includes: board membership and consulting or advisory. Joseph Brandwein reports a relationship with Pfizer that includes: board membership and consulting or advisory. Joseph Brandwein reports a relationship with Taiho Pharma Canada Inc that includes: board membership and consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
– Blood counts and supportive medications from start of induction for case #1. Aza = azacitidine; ven = venetoclax; EPO = epoetin; BMBx = bone marrow biopsy; CR = complete remission.
Fig. 2
Fig. 2
– Blood counts and supportive medications from start of induction for case #2. HU = hydroxyurea; ATO = arsenic trioxide; ATRA = all-trans retinoic acid; DBPOI = darbepoetin; BMBx = bone marrow biopsy; CR = complete remission.
See this image and copyright information in PMC

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