{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:27:15Z","timestamp":1787243235577,"version":"build-2736575974"},"reference-count":8,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Oncol"],"abstract":"<jats:p>Introduction: Acute myeloid leukemia (AML) treatment typically involves intensive chemotherapy associated with prolonged cytopenias and frequent transfusion requirements. Patients who decline blood products, such as Jehovah\u2019s Witnesses (JW), present a therapeutic challenge, as transfusion support is integral to standard care. Emerging low-intensity regimens combining venetoclax (VEN) with hypomethylating agents offer a potential alternative with reduced myelosuppression. Case Presentation: A 77-year-old male JW with AML with myelodysplastic syndrome-related changes and mutations in DDX41, ASXL1, and PPM1D presented with pancytopenia. Due to refusal of transfusions, he was treated with a metronomic, all-oral regimen of VEN 400 mg weekly and decitabine\/cedazuridine (DEC-C) 35\/100 mg weekly, supported by erythropoiesis-stimulating agent (darbepoetin alfa) and thrombopoietin agonist (romiplostim) as needed. After 4 weeks, bone marrow blasts decreased from 20\u201325% to 10%, with clearance of ASXL1 and PPM1D mutations and reduction of DDX41 variant allele frequency (VAF) to 2.9% from 9.7%. At 26 weeks, marrow blasts further decreased to 5%, DDX41 VAF remained low (2.6%), and counts normalized (ANC 1.73 \u00d7 103\/\u00b5L, hemoglobin 13.1 g\/dL, PLT 256 \u00d7 103\/\u00b5L) without any transfusions. Conclusion: This case demonstrates that a metronomic, all-oral VEN and DEC-C regimen can achieve hematologic improvement and molecular response in AML while maintaining transfusion independence. It highlights a feasible and safe therapeutic option for patients declining blood products, achieving disease control with minimal toxicity.<\/jats:p>","DOI":"10.1159\/000551645","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:00:44Z","timestamp":1784131244000},"page":"1268-1274","source":"Crossref","is-referenced-by-count":0,"title":["Weekly Metronomic Venetoclax and Decitabine\/Cedazuridine in Acute Myeloid Leukemia Patient Declining Blood Transfusion"],"prefix":"10.1159","volume":"19","author":[{"given":"Mahmood","family":"Aldapt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talha","family":"Badar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine N.","family":"Saliba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Foran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney","family":"Bianco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Hanratty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4534-4248","authenticated-orcid":false,"given":"Hemant","family":"Murthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022016867"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0902-4441.2003.00211.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-08-868752"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25916"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1080\/10245332.2017.1411548"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.lrr.2024.100477"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-23-0842"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2025.43.16_suppl.6504"}],"container-title":["Case Reports in Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000551645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:01:27Z","timestamp":1787241687000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000551645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000551645","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32990066","asserted-by":"subject"}]},"ISSN":["1662-6575"],"issn-type":[{"value":"1662-6575","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]}}}