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Bloodless cancer treatment results of patients who do not want blood transfusion: single center experience of 77 cases

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Abstract

Purpose

Certain patients may be unwilling to accept blood products for religious reasons. In this study, we have assessed the clinical cancer treatment outcomes of Jehovah’s Witnesses (JW) cancer patients in order to identify the risks associated with their treatment, as well as their transfusion needs.

Methods

We analyzed 77 cases of histologically confirmed cancer patients (JW) from January 2001 to April 2008.

Results

The median age of the patients was 59 years (range, 8–83 years). The most common primary site was the stomach (20.8%), followed by the breast (14.3%), and colorectal region (11.7%). Operations were performed on 44 patients (89.8%). Changes in complete blood count profiles after operation were detected in the patients’ hemoglobin (mean ± SD; 12.7 ± 2.1 g/dL to 10.6 ± 2.3 g/dL, P < 0.001). Twenty-six patients received adjuvant chemotherapy. Among these, 21 (80.8%) completed their planned schedule. One hundred twenty-seven cycles of palliative intravenous chemotherapy were administered to 19 patients. Granulocyte-colony stimulating factor and erythropoietin were used in 45 and 20 cycles of treatment, respectively. Grade ≥III thrombocytopenia and anemia were noted in 3.9% and 2.4% of the patients. Three- and 5-year survival rates were 80% and 70%, respectively. The most frequent cause of death was disease progression rather than bleeding.

Conclusions

Bloodless cancer operation and chemotherapy were not accompanied by serious complications. A few cases of palliative chemotherapy also required transfusions. A prospective cohort study group will need to be used to determine precisely the safety of bloodless cancer treatment and the efficacy of transfusion alternatives.

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Acknowledgment

This paper was supported by the Dong-A University Research Fund and the Korea Science and Engineering Foundation (KOSEF) grant funded by the Korea government (MEST; R13-2002-044-05001-0).

Conflict of Interest

The authors declare that have no competing interests.

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Authors and Affiliations

  1. Department of Internal Medicine, Dong-A University College of Medicine, 3-1 Dongdaeshin-dong, Seo-gu, Busan, 602-715, South Korea

    Sung Yong Oh, Sung-Hyun Kim, Hyuk-Chan Kwon, Suee Lee, Kyung A Kwon & Hyo-Jin Kim

  2. Laboratory Medicine, Dong-A University College of Medicine, 3-1 Dongdaeshin-dong, Seo-gu, Busan, 602-715, South Korea

    Kyeong Hee Kim

  3. Bloodless center, Dong-A University College of Medicine, 3-1 Dongdaeshin-dong, Seo-gu, Busan, 602-715, South Korea

    Sung Yong Oh, Kyeong Hee Kim, Jong-Hwan Lee & Kyu-Yeol Lee

  4. Medical Research Center for Cancer Molecular Therapy, Dong-A University College of Medicine, 3-1 Dongdaeshin-dong, Seo-gu, Busan, 602-715, South Korea

    Sung Yong Oh & Hyuk-Chan Kwon

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  1. Sung Yong Oh
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Correspondence to Hyo-Jin Kim.

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Oh, S.Y., Kim, SH., Kwon, HC. et al. Bloodless cancer treatment results of patients who do not want blood transfusion: single center experience of 77 cases. Support Care Cancer 18, 1341–1346 (2010). https://doi.org/10.1007/s00520-009-0759-3

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  • DOI: https://doi.org/10.1007/s00520-009-0759-3

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