Bloodless Treatment in Jehovah’s Witnesses with Acute Myeloid Leukemia

Abstract

Jehovah’s Witnesses are a millenarian Christian faith with approximately 8.5 million adherents worldwide involved in evangelism and a much larger number (nearly 20 million) who associate with them.1 In Thailand, there are more than 5,000 Jehovah’s Witnesses. They value life and accept the vast majority of medical treatments. However, they do not accept allogeneic blood transfusion therapy because of their understanding of Biblical statements to abstain from blood. We report the case of a Thai woman who presented with pruritus for 6 weeks and was diagnosed acute myeloid leukemia (AML). She received treatment without any blood component transfusion and achieved complete remission. We also used measures and drugs that alleviated anemia and bleeding problems in order to avoid blood transfusion. Because the number of Jehovah’s Witnesses is increasing, growing numbers of non-Witness patients prefer treatment without blood transfusion, and because blood inventory shortages, safety, and blood costs continue to be of concern in many countries, this is a relevant topic for clinicians. Management of patients without allogeneic blood is a medical and ethical challenge for medical practitioners in Thailand, but it can be met as we show in this case report.