Treatment of acute leukaemia in adult Jehovah's Witnesses

Abstract

Summary Since Jehovah’s Witness (JW) patients diagnosed with leukaemia refuse blood transfusions, they are often denied intensive chemotherapy for fear they could not survive myeloablation without blood transfusion support. Treatment of JW patients with acute leukaemia is challenging and carries a higher morbidity and mortality; however, the refusal of blood products should not be an absolute contraindication to offer multiple treatment modalities including haematopoietic stem cell transplantation. In this review we discuss their optimal management and describe alternative modalities to blood transfusions to provide sufficient oxygenation and prevent bleeding.

NCCN Guidelines Insights: Acute Myeloid Leukemia, Version 2.2021

“…55 During treatment, measures should be taken to minimize blood loss and decrease the risk of bleeding, including use of pediatric collection tubes, avoiding concomitant medications or procedures that increase the risk of bleeding or myelosuppression, use of oral contraceptive pills or medroxyprogesterone acetate in menstruating women, or administration of proton pump inhibitors, as indicated. 50,57 Vitamin K may be considered as an adjuvant to improve coagulopathy. 50,57 In patients at risk for bleeding (eg, when platelet counts decrease to ,30,000/mcL), aminocaproic or tranexamic acid may be considered to manage bleeding.…”

“…50,57 Vitamin K may be considered as an adjuvant to improve coagulopathy. 50,57 In patients at risk for bleeding (eg, when platelet counts decrease to ,30,000/mcL), aminocaproic or tranexamic acid may be considered to manage bleeding. 50,57 In patients with elemental or vitamin deficiencies, iron, folate, and vitamin B12 supplementation should be considered.…”

“…50,57 In patients at risk for bleeding (eg, when platelet counts decrease to ,30,000/mcL), aminocaproic or tranexamic acid may be considered to manage bleeding. 50,57 In patients with elemental or vitamin deficiencies, iron, folate, and vitamin B12 supplementation should be considered. 50,57 In patients with severe anemia, bed rest and supplemental oxygenation should be considered.…”

“…50,57 In patients with elemental or vitamin deficiencies, iron, folate, and vitamin B12 supplementation should be considered. 50,57 In patients with severe anemia, bed rest and supplemental oxygenation should be considered. 50,57…”

“…50,57 In patients with severe anemia, bed rest and supplemental oxygenation should be considered. 50,57…”