Expert Cancer Panel: Jehovah’s witness w/ multiple myeloma s/p RVD under evaluation for auto SCT

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Published
Recorded on 5/22/2021

65-year-old Jehovah’s witness with multiple myeloma in remission after RVD under evaluation for autologous-SCT.

Summary:
- There is no contraindication for treating a patient who declines transfusions with standard induction therapy for myeloma. An erythropoietin stimulating agent may be considered if necessary. However if an ESA is used along with lenalidomide, consider escalating thromboembolic prophylaxis from aspirin to anticoagulation with a DOAC or LMH.
- Autologous stem cell transplant is not curative in myeloma, and the decision to pursue this in a patient who declines transfusions may pose a higher risk of complications, and the decision must be individualized. There are “bloodless” specialized transplant centers in the U.S. that will accommodate such patients.


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Category
Oncology
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