Use of platelet and erythroid growth factors during induction chemotherapy for acute lymphoblastic leukaemia in a Jehovah's Witness

BMJ Case Rep. 2018 Dec 7;11(1):e226497. doi: 10.1136/bcr-2018-226497.

Abstract

We present a 21-year-old woman diagnosed with Philadelphia (Ph) chromosome-like CD20 positive B-cell acute lymphoblastic leukaemia (ALL). She was a Jehovah's Witness (JW) and declined all blood product transfusion support. She was initiated on the CALGB 10403 chemotherapy protocol for her ALL. She received darbepoetin alfa and romiplostim as supportive therapies for her disease/chemotherapy-associated anaemia and thrombocytopaenia. A complete remission was achieved with negative minimal residual disease and she remains in remission 18 months after diagnosis. This case report describes the successful treatment of an adult JW with Ph-like CD20 +B cell ALL, in the absence of blood product transfusions, using growth factor support.

Keywords: healthcare improvement and patient safety; malignant and benign haematology; therapeutic indications.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Darbepoetin alfa / therapeutic use*
  • Female
  • Hematinics / therapeutic use*
  • Humans
  • Induction Chemotherapy / methods*
  • Jehovah's Witnesses*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Receptors, Fc / therapeutic use*
  • Receptors, Thrombopoietin / agonists*
  • Recombinant Fusion Proteins / therapeutic use*
  • Remission Induction
  • Thrombopoietin / therapeutic use*
  • Treatment Refusal
  • Young Adult

Substances

  • Hematinics
  • Receptors, Fc
  • Receptors, Thrombopoietin
  • Recombinant Fusion Proteins
  • Darbepoetin alfa
  • Thrombopoietin
  • romiplostim