• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Oncology

Autologous stem-cell transplantation may be safe without transfusion support

byMonica ParksandDavid Wang
April 26, 2015
in Oncology
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. In a prospective cohort study of over 120 Jehovah’s Witnesses with lymphoma and multiple myeloma, high-dose chemotherapy (HDC), and autologous stem-cell transplantation (ASCT) without transfusion support was associated with relatively low mortality and morbidities.

Evidence Rating Level: 3 (Average)

Study Rundown: The standard of care for high risk or recurrent lymphoma and multiple myeloma (MM) is high dose chemotherapy (HDC) followed by autologous stem cell transplantation (ASCT). However, patients who refuse blood product transfusions, such as Jehovah’s Witnesses (JW), may encounter medical complications due to concern for bleeding and anemia. The purpose of this prospective cohort study was to describe the mortality and morbidities seen in patients undergoing this treatment regimen without transfusion. Overall, 125 JW were treated with HDC and ASCT and were provided basic blood management techniques (e.g. intravenous iron, limiting phlebotomy). At the conclusion of the trial, the authors found that treatment related mortality at 30 days follow-up was 4.8%. The main adverse events within this cohort were cardiac complications, which occurred in 32% of patients. Furthermore, bleeding complications were low within this cohort. The results of this trial support the safety of ASCT in the JW population without transfusion support. Although the treatment related-mortality is higher than the national average (1%-3.5%), the low rate may be acceptable given the JW’s special characteristic. The study was limited by relatively small sample size. Additional large, prospective trials are needed to confirm the risks and adverse event incidence.

Click to read the study in JCO

Relevant Reading: The threshold for prophylactic platelet transfusions in adults with acute myeloid leukemia

In-Depth [prospective cohort]: This study described the outcome of 125 JW treated with ASCT without transfusion support. The median age at enrollment was 52 years old. The indications for treatment included lymphoma (n=55), multiple myeloma (MM) (n=68), and amyloidosis (n=2). Blood conservation techniques included limited phlebotomy, gastrointestinal and genitourinary bleeding prophylaxis with proton pump inhibitors and hormonal contraceptives, avoidance of heparin and antiplatelet agents, and prophylactic phytonadione. The outcomes of interest were treatment-related mortality (TRM) (mortality after 30 days of ASCT) and adverse events. Overall, TRM occurred in 4.8% of patients (n=6), due to profound anemia (n = 1), severe sepsis (n = 1), multi-organ failure secondary to pancytopenia (n = 1) and cardiac events (n = 3). Cardiac complications occurred in 32% (n=40) of patients, most commonly arrhythmias (n=20), congestive heart failure (n=15), and hypotension (n=17). There were three deaths associated with cardiac complications. There were a total of 18 bleeding episodes, with the majority being grade 1 bleeds (e.g. conjunctival hemorrhage, epistaxis). There were no bleeding-associated mortalities.

Image: PD

RELATED REPORTS

#VisualAbstract ESCORT-HU highlights the real-life positive benefit-to-risk ratio of hydroxyurea in patients with sickle cell disease

#VisualAbstract Lenalidomide shows improvement in progression-free survival over bortezomib maintenance following autologous stem cell transplantation for multiple myeloma

#VisualAbstract Higher rate of hematologic second primary malignancies developed in multiple myeloma patients who received autologous hematopoietic stem cell transplants

©2015 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: autologous stem cell transplantationblood transfusion
Previous Post

30-Day mortality decreased in UK pediatric cardiac surgery from 2000-2010

Next Post

Disruption of malaria treatment due to Ebola may increase malaria mortality

RelatedReports

#VisualAbstract ESCORT-HU highlights the real-life positive benefit-to-risk ratio of hydroxyurea in patients with sickle cell disease
StudyGraphics

#VisualAbstract ESCORT-HU highlights the real-life positive benefit-to-risk ratio of hydroxyurea in patients with sickle cell disease

October 8, 2021
#VisualAbstract Lenalidomide shows improvement in progression-free survival over bortezomib maintenance following autologous stem cell transplantation for multiple myeloma
StudyGraphics

#VisualAbstract Lenalidomide shows improvement in progression-free survival over bortezomib maintenance following autologous stem cell transplantation for multiple myeloma

January 28, 2021
#VisualAbstract Higher rate of hematologic second primary malignancies developed in multiple myeloma patients who received autologous hematopoietic stem cell transplants
StudyGraphics

#VisualAbstract Higher rate of hematologic second primary malignancies developed in multiple myeloma patients who received autologous hematopoietic stem cell transplants

January 21, 2021
#VisualAbstract Fondazione Italiana Linfomi (FIL) Phase 3 trial: Lenalidomide maintenance after autologous haematopoietic stem-cell transplantation (HSCT) in mantle cell lymphoma improves progression-free survival (PFS)
Chronic Disease

#VisualAbstract Fondazione Italiana Linfomi (FIL) Phase 3 trial: Lenalidomide maintenance after autologous haematopoietic stem-cell transplantation (HSCT) in mantle cell lymphoma improves progression-free survival (PFS)

January 8, 2021
Next Post
Insecticidal bed nets linked with reduced transmission of lymphatic filariasis

Disruption of malaria treatment due to Ebola may increase malaria mortality

New vaccine shown to prevent a significant number of malaria cases in phase 3 trial

New vaccine shown to prevent a significant number of malaria cases in phase 3 trial

AAP policy addresses appropriate discharge timing for healthy term newborns

AAP policy addresses appropriate discharge timing for healthy term newborns

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Faecal haemoglobin concentrations associated with mortality and cause of death in colorectal cancer screening
  • The Scan by 2 Minute Medicine®: Maternity Leave Left Out, Dry January, A Measles Resurgence, Dr. GPT
  • Former professional football players may be at greater risk of chronic disease
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options