Transfusion-free reduced-intensity conditioned allogeneic stem cell transplantation in a Jehovah's witness

With an estimated 6000000 Jehovah's witnesses worldwide, haematologists may encounter patients who decline blood transfusions as a matter of personal belief. Here, we describe the first case of a transfusion-free allogeneic stem cell transplant (SCT) in a Jehovah's witness with CML. The patient underwent HLA-identical peripheral blood SCT after reduced-intensity conditioning with total body irradiation and fludarabine. Conditioning and the period after transplantation were uneventful, complete donor chimerism was achieved and the patient continues to be in molecular remission without significant chronic graft-versus-host disease. When treating Jehovah's witnesses with diseases that may be cured by allogeneic SCT, this approach should be kept in mind.