USE OF ERYTHROPOIETIN AND PARENTERAL IRON DEXTRAN IN A SEVERELY ANEMIC JEHOVAH-WITNESS WITH COLON-CANCER

A Jehovah's Witness presented with colon cancer and profound anemia. O n admission, her hemoglobin level was 30 g/L (3.0 g/dL). She refused a ll transfusions and failed to respond to oral iron therapy. She was ul timately prepared for surgery using recombinant human erythropoietin, iron dextran, and total parenteral nutrition. It took nearly 1 month t o increase her hemoglobin level to an acceptable preoperative level of 110 g/L (11.0 g/dL). During the postoperative period, erythropoietin and parenteral iron therapy were briefly continued and a follow-up hem oglobin level of greater than 120 g/L (12.0 g/dL) was observed. Recomb inant human erythropoietin, along with parenteral iron and adequate nu trition, may be useful in patients who refuse transfusion or cannot be transfused because of difficult cross-reacting antibodies.