Background: Patients with multiple myeloma often experience severe anaemia, complicating management, especially when they object to blood transfusion due to religious beliefs.
Objective: To present a successful management approach for severe anaemia in a patient with multiple myeloma who refused blood transfusion.
Methods: We present a case of a 58-year-old male patient with multiple myeloma who objected to blood transfusion due to his religious beliefs. The presenting haemoglobin level ( Hb) was 2.5g/dl, with signs and symptoms of heart failure and hyperviscosity syndrome. We resuscitated the patient and commenced Hb optimisation using intravenous iron, intravenous vitamin C, intravenous Vitamin B complex, and subcutaneous human recombinant erythropoietin Beta.
Results: The patient progressed from a wheelchair to independent walking, achieved remission, and saw haemoglobin rise to 8 g/dL. Stable blood pressure and PCV (30-35%) indicated successful management.
Conclusion: It is possible to manage very severe anaemia without blood transfusion in patients with multiple myeloma. We recommend clinical trials on managing anaemia without blood transfusion in multiple myeloma patients. This strategy will benefit many patients who need treatment in settings where transfusion is not possible and especially where blood transfusion is not an option.
Key words: Multiple Myeloma, Quality of Life, Blood transfusion, Anaemia
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