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Evaluate clinical outcomes of erythropoietin and intravenous iron in patients with critical anemia declining transfusion due to religious beliefs.

December 8, 2025BloodOpen Access

Efficacy of erythropoietin and intravenous iron for treatment of critical anemia in patients who decline blood transfusions for religious reasons

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Observational study shows erythropoietin improves hemoglobin in critical anemia without blood transfusions, implying alternative treatment is viable.

Evaluate clinical outcomes of erythropoietin and intravenous iron in patients with critical anemia declining transfusion due to religious beliefs.
Retrospective single-arm observational study
Patient data from Montefiore Medical Center's electronic health records (2016-2025)
Included patients treated with erythropoietin for severe anemia who declined blood transfusions
74% of patients achieved hemoglobin recovery
Median increase in hemoglobin was 4.4 g/dL
14% in-hospital mortality rate observed
One thrombotic event occurred post-treatment

Olonoff et al. (2025) studied this question.

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Observational study shows erythropoietin improves hemoglobin in critical anemia without blood transfusions, implying alternative treatment is viable.