[Autologous Stem-Cell Transplantation without Transfusion Support in Jehovah's Witness Patients. A case series].

Abstract

Autologous Stem-Cell Transplantation (ASTC) has proven efficacy in several hematological malignancies. The greatest antineoplastic effect achieved with intensified chemotherapy is associated with severe myelotoxicity. The infusion of autologous hematopoietic precursors and transfusion support during the period of aplasia reduces the time and depth of cytopenias, decreasing the risk of bleeding, anemia and life-threatening infections. With the use of stimulants of the three main hematopoietic series, it has been possible to offer this treatment to patients who refuse to receive transfusions, such as Jehovah's Witnesses (JW). This article describes a local protocol to implement ASCT without transfusion support and shows our experience in four patients, two with multiple myeloma and two with relapsed/refractory lymphomas. Despite critical hemoglobin and platelet values observed, no serious complications or treatment-related mortality were observed. At the time of the report, all patients were alive and without progression of their neoplasms. Autologous stem-cell transplantation without transfusion support is feasible in centers with experience in this procedure and can benefit JW among other populations.