title: Autologous stem-cell transplantation can be performed safely without the use of blood-product support.
abstract: OBJECTIVE
  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.
  
  
  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 10(9)/L was 4 days; the median days to platelet recovery greater than 20 x 10(9)/L was 12 days.
  
  
  CONCLUSIONS
  Autologous stem-cell transplantation can be performed safely without the use of any blood products.
authors.affiliation: Division of Hematology/Oncology, Massachusetts General Hospital, 100 Blossom St, Cox 640, Boston, MA 02114, USA. kballen@partners.org
authors.forename: Karen K
authors.initials: KK
authors.lastname: Ballen
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Becker
authors.forename: Beow Yong
authors.initials: BY
authors.lastname: Yeap
authors.forename: Barbara
authors.initials: B
authors.lastname: Matthews
authors.forename: David H
authors.initials: DH
authors.lastname: Henry
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ford
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D017370:Interleukin-11 / Q000627:therapeutic use; D033221:Jehovah's Witnesses; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D009503:Neutropenia / Q000209:etiology; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D010976:Platelet Count; D015996:Survival Rate; D014182:Transplantation, Autologous
chemical_list: D017370:Interleukin-11; D004921:Erythropoietin; D016179:Granulocyte Colony-Stimulating Factor