Complete remission induced by gemtuzumab ozogamicin in a Jehovah's witness patient with acute myelogenous leukemia

We report an interesting case of acute myelogenous leukemia (AML) in a Jehovah's Witness patient. A 61-year-old woman, a Jehovah's Witness, consulted our hospital because of continuous fever and refractory pharyngitis. The white blood cell count was increased with myeloblasts and monoblasts, both of which showed positivity for CD33. The level of WT1 messenger RNA (mRNA) in the bone marrow was 130,000 copies/mu g RNA. The patient's diagnosis was AML (M4). Because complete remission (CR) was not obtained with 2 courses of chemotherapy consisting of acrarubicin and cytarabine, we tried gemtuzumab ozogamicin (GO) with informed consent. No major side effects appeared, and CR was obtained after 2 courses of GO, which decreased the WT1. mRNA level to 480 copies/mu g RNA. ne patient has been in CR for 6 months with ubenimex. This case suggests that GO can be one of the treatment options in similar situations, although it should be used with considerable care.