Chojnowski Krzysztof, Janus Agnieszka, Bliźniewska Katarzyna, Robak Marta, Treliński Jacek
Department of Hemostasis, Medical University of Łódź, and the, Łódź, Poland.
Department of Hematology, Copernicus Memorial Hospital, Łódź, Poland.
Transfusion. 2016 Oct;56(10):2438-2442. doi: 10.1111/trf.13703. Epub 2016 Jul 7.
The treatment of patients with acute leukemia, who due to their religious beliefs refuse to accept blood transfusion, is a great challenge for hematologists.
We present a case of acute pre-T-lymphoblastic leukemia in a Jehovah's Witness who did not accept blood transfusion during chemotherapy. Standard induction and consolidation chemotherapy was used (according to the PALG ALL-6 regiment).
During consolidation cycles, darbepoietin alfa, intravenous iron, and total parenteral nutrition was administered. Extreme (Hb < 5 g/dL), long-lasting (41 days) anemia was observed with the lowest Hb concentration amounting to 1.3 g/dL (lasting 7 days).
We believe this to be the lowest Hb value observed, particularly one that persisted for such a long period of time and resulted in the patient surviving without consequences. The patient remains in complete remission for more than 2 years after diagnosis.
对于因宗教信仰拒绝接受输血的急性白血病患者，其治疗对血液科医生而言是巨大挑战。
我们呈现1例耶和华见证会成员患急性前T淋巴细胞白血病，在化疗期间不接受输血。采用了标准诱导和巩固化疗（根据PALG ALL - 6方案）。
在巩固周期中，给予了聚乙二醇化促红细胞生成素α、静脉铁剂和全胃肠外营养。观察到严重（血红蛋白<5 g/dL）、持续时间长（41天）的贫血，最低血红蛋白浓度达1.3 g/dL（持续7天）。
我们认为这是所观察到的最低血红蛋白值，尤其是持续如此长时间且患者无不良后果存活的情况。患者确诊后完全缓解超过2年。
