Page David, Sawler Daniel, Brandwein Joseph
Division of Hematology, Department of Medicine, University of Alberta, Edmonton Alberta Canada.
Leuk Res Rep. 2024 Aug 8;22:100477. doi: 10.1016/j.lrr.2024.100477. eCollection 2024.
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.
接受诱导化疗的急性髓系白血病（AML）患者会接受输血支持以应对严重血细胞减少及相关后遗症。耶和华见证会（JW）的患者通常会拒绝输注大多数或全部血液制品。出于安全考虑，这可能导致JW患者被排除在原本可挽救生命的治疗之外。我们展示了两例成功诱导JW患者的病例，无需红细胞或血小板输血支持；第一例是一名老年AML患者，使用阿扎胞苷和维奈克拉进行诱导治疗；第二例是一名急性早幼粒细胞白血病患者，使用三氧化二砷和全反式维甲酸进行诱导治疗。两名患者都需要对诱导方案进行调整以满足他们的意愿。这些病例支持了越来越多的证据，即通过适当的调整，部分患有AML的JW患者可以得到成功治疗。
