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Case Reports in Hematology
Volume 2014 (2014), Article ID 141260, 4 pages
http://dx.doi.org/10.1155/2014/141260
Case Report

A Jehovah’s Witness with Acute Myeloid Leukemia Successfully Treated with an Epigenetic Drug, Azacitidine: A Clue for Development of Anti-AML Therapy Requiring Minimum Blood Transfusions

1Metropolitan Research Center for Blood Disorders (MRC Japan), 1-45-46 Midorigaoka, Chofu, Tokyo 182-0001, Japan
2Department of General Medicine, Shin-Yurigaoka General Hospital, Furusawa Tsuko 255, Asaoku, Kawasaki, Kanagawa 215-0026, Japan
3Department of Hematology, Shin-Yurigaoka General Hospital, Furusawa Tsuko 255, Asaoku, Kawasaki, Kanagawa 215-0026, Japan

Received 17 July 2014; Accepted 23 September 2014; Published 2 October 2014

Academic Editor: Ramon Tiu

Copyright © 2014 Yumi Yamamoto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Therapy for acute leukemia in Jehovah’s Witnesses patients is very challenging because of their refusal to accept blood transfusions, a fundamental supportive therapy for this disease. These patients are often denied treatment for fear of treatment-related death. We present the first Jehovah’s Witness patient with acute myeloid leukemia (AML) treated successfully with azacitidine. After achieving complete remission (CR) with one course of azacitidine therapy, the patient received conventional postremission chemotherapy and remained in CR. In the case of patients who accept blood transfusions, there are reports indicating the treatment of AML patients with azacitidine. In these reports, azacitidine therapy was less toxic, including hematoxicity, compared with conventional chemotherapy. The CR rate in azacitidine-treated patients was inadequate; however, some characteristics could be useful in predicting azacitidine responders. The present case is useful for treating Jehovah’s Witnesses patients with AML and provides a clue for anti-AML therapy requiring minimum blood transfusions.