Decitabine for acute myeloid leukemia in a patient undergoing hemodialysis

Treatment of patients with Acute Myeloid Leukemia (AML) undergoing hemodialysis is especially challenging since there are no specific management guidelines for the administration of cytotoxic agents in these patients. Well established chemotherapy protocols may be unsuitable in such cases because of altered drug pharmacokinetics, increased risk for complications, and underlying co-morbidities. In addition, these patients are at an increased risk for complications such as tumor lysis syndrome. Herein, we report the first use of decitabine in a patient on hemodialysis. He presented with a new diagnosis of AML and achieved hematologic remission following the use of induction chemotherapy and maintenance decitabine.