Successful autologous peripheral blood stem cell transplantation in a Jehovah's Witness with multiple myeloma: review of literature and recommendations for high-dose chemotherapy without support of allogeneic blood products

Int J Hematol. 2008 Apr;87(3):289-97. doi: 10.1007/s12185-008-0055-x. Epub 2008 Mar 4.

Abstract

We present a case report of a successful high-dose melphalan therapy and autologous stem cell transplantation without the use of allogeneic blood product support in a 70-year-old patient suffering from multiple myeloma. Based on the experience in this case and thorough evaluation of the literature, we consider pre-transplant Hb level of 11-12 g/dl, platelet count higher than 70/nl, good WHO performance status of two and lower and informed consent as important eligibility criteria. During cytopenia recommended supportive measures include growth factor support with erythropoietin and G-CSF, p.o. iron treatment as well as prophylactic use of anti-fibrinloytic agents. Furthermore we discuss additional options that might be considered depending on the individual factors as e.g. pre-transplant collection and cryoconservation of autologous platelet concentrates. Moreover, an analysis of socio-economic issues regarding this procedure is presented. We conclude that allogeneic blood product free transplantation is a feasible procedure that can be offered to the patients belonging to distinct religious groups refusing allogeneic blood products as Jehovás Witnesses and patients presenting other contraindications for transfusions.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Cryopreservation
  • Humans
  • Jehovah's Witnesses*
  • Male
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / therapy*
  • Peripheral Blood Stem Cell Transplantation*
  • Plateletpheresis
  • Remission Induction
  • Transplantation Conditioning*
  • Transplantation, Autologous