Thank you for your question.
I am an orthopedic surgeon, so this is outside my specialty. In general, however, the treatment of acute leukemia often requires blood transfusions, including red blood cells and platelets.
Whether treatment without transfusion is feasible depends on many factors such as disease subtype, severity, complications, and available alternatives, and must be assessed on a case-by-case basis.
This is exactly why I believe we need clearer institutional guidelines—so that individual physicians are not left to carry the full burden of these difficult decisions each time.