NoBlood

Journal:
Journal of Clinical Oncology, Vol 22, No 20 (October 15), 2004: pp. 4087-4094

Link:
http://www.jco.org/cgi/content/abstract/22/20/4087

Autologous Stem-Cell Transplantation Can Be Performed Safely Without the Use of Blood-Product Support

Karen K. Ballen, Pamela S. Becker, Beow Yong Yeap, Barbara Matthews, David H. Henry, Patricia A. Ford

From the Massachusetts General Hospital, Boston; University of Massachusetts Memorial Health Care, Worcester, MA; and Pennsylvania Hospital, Philadelphia, PA

PURPOSE: Autologous stem-cell transplantation has been shown to be a curative procedure for a variety of leukemias and lymphomas. Most transplants require RBC and platelet support. We report the ability to perform autologous transplantation without blood-product support.


SUBJECTS AND METHODS: In this study, we treated 26 patients with religious objection to blood products with autologous stem-cell support without the use of any blood products. Patients received a combination of granulocyte colony-stimulating factor (G-CSF), erythropoietin, and interleukin-11 or G-CSF alone to mobilize stem cells. Post-transplant patients received intravenous iron, erythropoietin, G-CSF, and epsilon aminocaproic acid.

RESULTS: There were two major bleeding complications (8%), with two treatment-related deaths (8%). There were three minor bleeding complications (12%). The median fall in hemoglobin level was 4.7 g/dL; the median hemoglobin level 30 days after transplantation was 9.2 g/dL. The median total number of days with platelet count less than 10 x 10⁹/L was 4 days; the median days to platelet recovery greater than 20 x 10⁹/L was 12 days. CONCLUSION: Autologous stem-cell transplantation can be performed safely without the use of any blood products.