Management of acute anemia in a Jehovah's Witness patient with acute lymphoblastic leukemia with polymerized bovine hemoglobin‐based oxygen carrier: a case report and review of literature

Donahue, Laura; Shapira, Iuliana; Shander, Aryeh; Kolitz, Jonathan E.; Allen, Sheila; Greenburg, Gerson

doi:10.1111/j.1537-2995.2010.02603.x

Cited by 40 publications

(22 citation statements)

References 41 publications

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“…The expected cost explosion in transfusion medicine resulting from an increasing imbalance between donors and recipients, and treatment of transfusion-associated complications, has increased the socio-economic significance of the development of safe and effective synthetic oxygen carriers as an alternative to the transfusion of allogeneic RBCs 139. However, a recent review of artificial oxygen carriers indicated that despite decades of preclinical and clinical research on them, the results were disappointing.…”

Section: Use Of Artificial Oxygen Carriersmentioning

confidence: 99%

The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood

Erhabor

Charles²

2011

JBM

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As a resource, allogenic blood has never been more in demand than it is today. Escalating elective surgery, shortages arising from a fall in supply, a lack of national blood transfusion services, policies, appropriate infrastructure, trained personnel, and financial resources to support the running of a voluntary nonremunerated donor transfusion service, and old and emerging threats of transfusion-transmitted infection, have all conspired to ensure that allogenic blood remains very much a vital but limited asset to healthcare delivery particularly in Sub-Saharan Africa. This is further aggravated by the predominance of family replacement and commercially remunerated blood donors, rather than regular benevolent, nonremunerated donors who give blood out of altruism. The demand for blood transfusion is high in Sub-Saharan Africa because of the high prevalence of anemia especially due to malaria and pregnancy-related complications. All stakeholders in blood transfusion have a significant challenge to apply the best available evidenced-based medical practices to the world-class management of this precious product in a bid to using blood more appropriately. Physicians in Sub-Saharan Africa must always keep in mind that the first and foremost strategy to avoid transfusion of allogenic blood is their thorough understanding of the pathophysiologic mechanisms involved in anemia and coagulopathy, and their thoughtful adherence to the evidenced-based good practices used in the developed world in a bid to potentially reduce the likelihood of allogenic blood transfusion in many patient groups. There is an urgent need to develop innovative ways to recruit and retain voluntary low-risk blood donors. Concerns about adverse effects of allogenic blood transfusion should prompt a review of transfusion practices and justify the need to search for transfusion alternatives to decrease or avoid the use of allogenic blood. These strategies should include the correction of anemia using pharmacological measures (use of antifibrinolytics to prevent bleeding and the use of erythropoietin and oral and intravenous iron to treat anemia) use of nonpharmacologic measures (preoperative autologous blood transfusion, perioperative red blood cell salvage and normothermia to reduce blood loss in surgical patients). All these strategies will help optimize the use of the limited blood stocks.

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Section: Use Of Artificial Oxygen Carriersmentioning

confidence: 99%

The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood

Erhabor

Charles²

2011

JBM

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“…Under the FDA's Expanded Access program, Hemopure has been used to treat severe anemia in JW patients after induction chemotherapy for leukemia, 36 burns, 37 trauma, 38 and autoimmune hemolytic anemia. 39 Hemopure or HBOCs are not a replacement for human allogeneic blood transfusion, but in cases of lifethreatening anemia in JW patients for which blood transfusion is not an option, it may be life-saving.…”

Section: Hbocsmentioning

confidence: 99%

How do we treat life‐threatening anemia in a Jehovah's Witness patient?

Posluszny

Napolitano

2014

Transfusion

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The refusal of allogeneic human blood and blood products by Jehovah's Witness (JW) patients complicates the treatment of life-threatening anemia. For JW patients, when hemoglobin (Hb) levels decrease beyond traditional transfusion thresholds (<7 g/dL), alternative methods to allogeneic blood transfusion can be utilized to augment erythropoiesis and restore endogenous Hb levels. The use of erythropoietin-stimulating agents and intravenous iron has been shown to restore red blood cell and Hb levels in JW patients, although these effects may be significantly delayed. When JW patients have evidence of life-threatening anemia (Hb <5 g/dL), oxygen-carrying capacity can be supplemented with the administration of Hb-based oxygen carriers (HBOCs). Although HBOCs are not Food and Drug Administration (FDA) approved, they may be obtained and administered with FDA, institutional review board, and patient approval. We describe a protocol-based algorithm to the management of life-threatening anemia in JW patients and review time to anemia reversal and patient outcomes using this approach.

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“…11 The majority of these cases involved patients who were JWs. [6][7][8]10,11 Herein, we describe a case of severe anemia secondary to wAIHA in a patient who refused RBC transfusion on religious grounds. He was treated with Hemopure under a compassionate use protocol, in addition to high-dose steroids, while awaiting definitive treatment with splenic artery embolization.…”

mentioning

confidence: 99%

Difficult to swallow: warm autoimmune hemolytic anemia in a Jehovah's Witness treated with hemoglobin concentrate complicated by achalasia

et al. 2016

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Management of acute anemia in a Jehovah's Witness patient with acute lymphoblastic leukemia with polymerized bovine hemoglobin‐based oxygen carrier: a case report and review of literature

Cited by 40 publications

References 41 publications

The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood

The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood

How do we treat life‐threatening anemia in a Jehovah's Witness patient?

Difficult to swallow: warm autoimmune hemolytic anemia in a Jehovah's Witness treated with hemoglobin concentrate complicated by achalasia

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