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.