title: Successful Treatment of Severe Anemia using Erythropoietin in a Jehovah Witness with Non-Hodgkin Lymphoma.
abstract: Blood transfusion many times works in a life-saving way when a patient is facing a critical situation. However, some patients, such as Jehovah's Witnesses, may refuse their administration because it opposes to their religion beliefs. Thus, clinicians are forced to respect patients' preferences and seek other treatments in order to overcome the obstacle of the transfusion. In 1989, recombinant human erythropoietin (rHuEPO) was approved by the United States Food and Drug Administration (FDA) for the treatment of anemia associated with chronic renal failure. This is an amino acid glycol-protein that stimulates red blood cell production in the same manner as endogenous erythropoietin. Other treatment indications approved by the FDA include anemia due to chronic kidney disease, anemia secondary to zidovudine therapy in patients with human immunodeficiency virus infection, and anemia secondary to cancer chemotherapy. The drug also has been used for many off-label indications. Many Jehovah's Witnesses have accepted rHuEPO as a treatment option to maintain and enhance erythropoiesis. This paper reports the case of a 57-year-old Jehovah's Witness man, who was diagnosed with severe anemia due to aggressive non Hodgkin lymphoma and refused transfusion of blood; thanks to the treatment with rHuEPO he has managed to complete chemotherapy and has survived a life threatening situation.
authors.affiliation: Department of Hematology, Second Propaedeutic Internal Medicine, Aristotle University of Thessaloniki , Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Agapidou
authors.affiliation: Department of Hematology, Second Propaedeutic Internal Medicine, Aristotle University of Thessaloniki , Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Vakalopoulou
authors.affiliation: Department of Hematology, Second Propaedeutic Internal Medicine, Aristotle University of Thessaloniki , Greece.
authors.forename: Theodosia
authors.initials: T
authors.lastname: Papadopoulou
authors.affiliation: Department of Hematology, Second Propaedeutic Internal Medicine, Aristotle University of Thessaloniki , Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Chadjiaggelidou
authors.affiliation: Department of Hematology, Second Propaedeutic Internal Medicine, Aristotle University of Thessaloniki , Greece.
authors.forename: Vasileia
authors.initials: V
authors.lastname: Garypidou
keywords: Jehovah’s Witness; erythropoietin; lymphoma; rHuEPO