Abstract
Allogeneic hematopoietic stem cell transplantation (alloHSCT) poses challenges for patients who decline blood products because of religious beliefs or other reasons. Despite potential curative prospects, many institutions refrain from offering alloHSCT to patients who decline blood products because of safety concerns associated with cytopenias. This review focuses on one institution's experience of conducting alloHSCT without blood components, emphasizing preparation and supportive care. The approach of conducting alloHSCT without blood components, which involves ABO-compatible donor matching, nonmyeloablative regimens, and pretransplantation optimization of red blood cell production, is discussed. The clinical team can minimize transfusion needs by using erythropoiesis-stimulating agents, thrombopoietin agonists, and peri- and post-transplantation management strategies. These recommendations can ensure patient safety and successful outcomes with bloodless medicine.
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