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Use of platelet and erythroid growth factors during induction chemotherapy for acute lymphoblastic leukaemia in a Jehovah’s Witness
  1. Nivedita Arora1,
  2. Arjun Gupta1,
  3. Hsiao C Li2,3 and
  4. Navid Sadeghi2,3
  1. 1 Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA
  2. 2 Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA
  3. 3 Parkland Health and Hospital System, Dallas, Texas, USA
  1. Correspondence to Dr Navid Sadeghi, navid.sadeghi{at}


We present a 21-year-old woman diagnosed with Philadelphia (Ph) chromosome-like CD20 positive B-cell acute lymphoblastic leukaemia (ALL). She was a Jehovah’s Witness (JW) and declined all blood product transfusion support. She was initiated on the CALGB 10403 chemotherapy protocol for her ALL. She received darbepoetin alfa and romiplostim as supportive therapies for her disease/chemotherapy-associated anaemia and thrombocytopaenia. A complete remission was achieved with negative minimal residual disease and she remains in remission 18 months after diagnosis. This case report describes the successful treatment of an adult JW with Ph-like CD20 +B cell ALL, in the absence of blood product transfusions, using growth factor support.

  • therapeutic indications
  • malignant and benign haematology
  • healthcare improvement and patient safety

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  • Contributors NA, AG, HCL and NS were involved in the conception and design, acquisition, analysis and interpretation of data, drafting the article or revising it critically for important intellectual content and gave final approval of the version published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.