A Single-institution Experience of Performing Bloodless Transplant in Jehovah's Witness Patients

Publication date: Available online 27 December 2018Source: Hematology/Oncology and Stem Cell TherapyAuthor(s): Alexander Coltoff, Aditya Shreenivas, Solmaz Afshar, Amir SteinbergAbstractAutologous stem cell transplant has been shown to prolong survival in multiple myeloma (MM). A common complication of the pre-transplant conditioning chemotherapy is severe multi-lineage cytopenias, resulting in significant transfusion requirements. Jehovah's Witnesses are members of a religious group that do not accept the transfusion of blood products. Many large transplant centers refuse to perform transplantation in Jehovah's Witnesses due to the complexity of treating cytopenic patients without blood product transfusions. However, some transplant centers that specialize in “bloodless” medicine and surgery have successfully transplanted in Jehovah’s Witnesses without transfusion support. In order to maximize successful outcomes in this population, potential transplant candidates are treated with a variety of agents to maximize baseline hemoglobin and platelet counts. In preparation for the first two “bloodless” transplants for MM at our institution, we conducted a retrospective study of patients with MM who underwent a transplant in the preceding year. Of the 60 patients reviewed, only six required packed red blood cell transfusion, whereas 39 required at least one platelet transfusion. These findings helped us to design a novel protocol for a “bloodless” autologous transplan...
Source: Hematology Oncology and Stem Cell Therapy - Category: Cancer & Oncology Source Type: research