Originally published as JCO Early Release 10.1200/JCO.2004.01.144 on September 7 2004

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Autologous Stem-Cell Transplantation Can Be Performed Safely Without the Use of Blood-Product Support

From the Massachusetts General Hospital, Boston; University of Massachusetts Memorial Health Care, Worcester, MA; and Pennsylvania Hospital, Philadelphia, PA

Address reprint requests to Karen K. Ballen, MD, Division of Hematology/Oncology, Massachusetts General Hospital, 100 Blossom St, Cox 640, Boston, MA 02114; e-mail: kballen{at}partners.org

PURPOSE: Autologous stem-cell transplantation has been shown to be a curative procedure for a variety of leukemias and lymphomas. Most transplants require RBC and platelet support. We report the ability to perform autologous transplantation without blood-product support.

SUBJECTS AND METHODS: In this study, we treated 26 patients with religious objection to blood products with autologous stem-cell support without the use of any blood products. Patients received a combination of granulocyte colony-stimulating factor (G-CSF), erythropoietin, and interleukin-11 or G-CSF alone to mobilize stem cells. Post-transplant patients received intravenous iron, erythropoietin, G-CSF, and epsilon aminocaproic acid.

RESULTS: There were two major bleeding complications (8%), with two treatment-related deaths (8%). There were three minor bleeding complications (12%). The median fall in hemoglobin level was 4.7 g/dL; the median hemoglobin level 30 days after transplantation was 9.2 g/dL. The median total number of days with platelet count less than 10 x 10⁹/L was 4 days; the median days to platelet recovery greater than 20 x 10⁹/L was 12 days.

CONCLUSION: Autologous stem-cell transplantation can be performed safely without the use of any blood products.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

This article has been cited by other articles:

				P. A. Ford, B. A. Matthews, and N. M. Brown Reduced Rate of Infectious Complications Following Bloodless Autologous Peripheral Blood Stem Cell Transplants (APBSCT). Blood (ASH Annual Meeting Abstracts), November 16, 2006; 108(11): 5453 - 5453. [Abstract] [PDF]