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Long‐lasting extreme anemia during the therapy of acute lymphoblastic leukemia in a Jehovah's Witness patient
Author(s) -
Chojnowski Krzysztof,
Janus Agnieszka,
Bliźniewska Katarzyna,
Robak Marta,
Treliński Jacek
Publication year - 2016
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.13703
Subject(s) - medicine , lymphoblastic leukemia , anemia , blood transfusion , chemotherapy , pediatrics , leukemia , acute leukemia , surgery
BACKGROUND The treatment of patients with acute leukemia, who due to their religious beliefs refuse to accept blood transfusion, is a great challenge for hematologists. CASE REPORT We present a case of acute pre‐T‐lymphoblastic leukemia in a Jehovah's Witness who did not accept blood transfusion during chemotherapy. Standard induction and consolidation chemotherapy was used (according to the PALG ALL‐6 regiment). RESULTS During consolidation cycles, darbepoietin alfa, intravenous iron, and total parenteral nutrition was administered. Extreme (Hb < 5 g/dL), long‐lasting (41 days) anemia was observed with the lowest Hb concentration amounting to 1.3 g/dL (lasting 7 days). CONCLUSION We believe this to be the lowest Hb value observed, particularly one that persisted for such a long period of time and resulted in the patient surviving without consequences. The patient remains in complete remission for more than 2 years after diagnosis.