The treatment of acute lymphoblastic leukemia in Jehovah's Witnesses and patients who cannot accept blood products

Leuk Res Rep. 2022 Oct 25:18:100355. doi: 10.1016/j.lrr.2022.100355. eCollection 2022.

Abstract

Jehovah's Witnesses cannot accept blood products based upon religious beliefs, and when they present with acute leukemia, the ideal treatment strategy can be controversial. We present six cases of Jehovah's Witnesses with acute lymphoblastic leukemia and show that complete remission can be achieved without using anthracycline in 83% (5/6) of patients. We also report, for the first time in this population, that the use of agents with novel mechanisms of action, such as blinatumomab and nelarabine, is associated with minimal myelosuppression and can produce durable responses, with 2 of 6 patients still alive in CR3 at 4.9 and 6.6 years.

Keywords: Blinatumomab; Chemotherapy; Jehovah's Witness; Leukemia; Nelarabine.

Publication types

  • Case Reports