title: Long-term transfusion of polymerized bovine hemoglobin in a Jehovah's Witness following chemotherapy for myeloid leukemia: a case report.
abstract: A 52-year-old female Jehovah's Witness presented with relapsed secondary acute myeloid leukemia. Because of chemotherapy-induced anemia, she was infused with the bovine hemoglobin (Hb)-based oxygen carrier HBOC-201 (Biopure) as the sole means of transfusion support. HBOC-201 has only been used for management of acute hemorrhage, and its utility in providing longer term transfusion support is unknown. Over a period of 18 days, a total dose of 1230 g of HBOC-201 was delivered. Although the patient succumbed to the disease after 18 days of treatment, this case documents our experience with the highest dose and duration of HBOC-201 ever used. Although possible renal toxicity could not be definitively excluded, the homogeneous extraction of oxygen by the brain in the presence of and perhaps from HBOC-201 was demonstrated.
authors.affiliation: Blood Transfusion Service and the Department of Medicine, Massachusetts General Hospital, Boston, USA.
authors.forename: Yash P
authors.initials: YP
authors.lastname: Agrawal
authors.forename: Matthew
authors.initials: M
authors.lastname: Freedman
authors.forename: Zbigniew M
authors.initials: ZM
authors.lastname: Szczepiorkowski
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001802:Blood Substitutes / Q000008:administration & dosage* / Q000627:therapeutic use; D001803:Blood Transfusion / Q000379:methods; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism; D002417:Cattle; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006454:Hemoglobins / Q000008:administration & dosage* / Q000627:therapeutic use; D006485:Hemosiderin / Q000378:metabolism; D006801:Humans; D007262:Infusions, Intravenous; D033221:Jehovah's Witnesses; D007951:Leukemia, Myeloid / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D011108:Polymers / Q000008:administration & dosage; D049268:Positron-Emission Tomography; D011859:Radiography
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D001802:Blood Substitutes; D006454:Hemoglobins; D011108:Polymers; C080663:polymerized bovine hemoglobin; D004921:Erythropoietin; C096798:HBOC 201; D006485:Hemosiderin