A dream or reality: Consideration of 'bloodless' hematopoietic stem cell transplants for Jehovah's witness patients.

Michael MacNeill, Adrienne Fulford, Deanna Caldwell, Uday Deotare

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Article in Hematology, transfusion and cell therapy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Michael MacNeillDepartment of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Electronic address: mmacneill2022@meds.uwo.ca.

Adrienne FulfordLondon Regional Cancer Program, London Health Sciences Centre, London, ON, Canada.

Deanna CaldwellVictoria Hospital, London Health Sciences Centre, London, ON, Canada.

Uday DeotareDepartment of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada; Victoria Hospital, London Health Sciences Centre, London, ON, Canada; Division of Hematology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; The Centre for Quality, Innovation and Safety, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHematopoietic stem cell transplantation (HSCT) is an important part of treatment for many hematologic conditions. The high-dose chemotherapy used in HSCTs puts patients at risk of significant cytopenias which often necessitate blood product transfusions. Certain populations, including Jehovah's Witnesses, are unable to receive blood product transfusions during their transplant and thus, in the past, they have been seen as unsuitable candidates for transplantations. However, there has been growing evidence of the safety and efficacy of so-called "bloodless" HSCT protocols.

methodsThe most recent and relevant literature on "bloodless" transplants were identified through Embase, MEDLINE, and PubMed, and analyzed to construct a "bloodless" HSCT protocol at a Canadian centre. Since 2021, the regimen was utilized for four autologous transplantations in three different Jehovah's Witness patients.

resultsNone of the patients had a significant bleeding event nor a hemoglobin nadir below 8.0 g/dL. Minor bleeding events, predominantly mucositis, resolved with site-specific management. No patient had significant thrombocytopenia, and all the cell lines of patients had normalized without transfusions by the time of discharge. All patients were hospitalized for <30 days, similar to the experience of the centre with "regular" autologous transplants.

conclusionCareful planning and tailored regimens support the achievability of "bloodless" HSCTs in patients, such as Jehovah's Witnesses, allowing practitioners to provide care to a previously excluded group and minimize the use of blood products in all HSCT patients.

Indexed as

Autologous hematopoietic stem cell transplantationJehovah’s witnessMultiple myelomaNon-hodgkin’s lymphomaTransfusion

Identifiers

PMID40743665

DOI10.1016/j.htct.2025.103958

PMCPMC12335951

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