Korean J Med.  2023 Dec;98(6):300-308. 10.3904/kjm.2023.98.6.300.

Bloodless Treatment of Jehovah’s Witness Patients with Lymphoma and Multiple Myeloma

• Kim JY
• Jeong SY
• Yoon SY
• Lee MY
• Lee N
• Won JH
• Kim KH

• KMID: 2548707
• DOI: http://doi.org/10.3904/kjm.2023.98.6.300

Abstract

Background/Aims
Jehovah’s Witnesses refuse blood transfusions for religious reasons. Soonchunhyang University Hospital Seoul has operated a bloodless treatment center since 2000, and a database of bloodless treatment patients has been created. This study aimed to analyze the bloodless treatment outcomes of lymphoma and multiple myeloma patients.
Methods
We retrospectively analyzed data of patients diagnosed with lymphoma (22 patients) or multiple myeloma (seven patients) who were treated bloodlessly at Soonchunhyang University Hospital Seoul from 2006 to 2021.
Results
The 2-year survival rate for lymphoma patients was 66.6%, with 22.7% dying within 6 months of diagnosis. Those who died early (within 6 months) had a median hemoglobin level of 5.5 g/dL and a median platelet count of 50,142/µL. Dyspnea due to anemia was the most common symptom reported by patients at the end of life. Patients with multiple myeloma had a median survival of 60.3 months and a 2-year survival rate of 57.1%. Although three of the seven multiple myeloma patients were eligible for autologous stem cell transplantation, they were treated with chemotherapy only due to limitations of the bloodless treatment. The drug type and intensity were adjusted due to hematological toxicities in 71.4% of multiple myeloma patients.
Conclusions
A significant proportion of patients completed their planned course of chemotherapy and achieved long-term survival. The treatments of some patients were adjusted due to the use of bloodless treatment at the initial chemotherapy session, which affected their response to treatment.

Keyword

Bloodless treatment; Lymphoma; Multiple myeloma; 무수혈; 림프종; 다발골수종