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.

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