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

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.