Abstract
Ramadan fasting induces significant physiological adaptations that can affect patients with hematological disorders. While fasting is generally safe for healthy individuals, reduced hydration and nutritional intake during the 13-18 hour fasting period can pose risks for those with anemia, coagulopathies, or malignancies. High-risk patients - such as those on intensive chemotherapy, post stem-cell transplantation, or with severe anemia (hemoglobin <8 g/dL) - are advised not to fast to avoid complications (e.g. vaso-occlusive crises, thrombotic events, or worsening anemia). Patients with stable hematologic conditions, however, may fast safely with careful pre-Ramadan evaluation, medication timing adjustments, and strict hydration and nutrition plans. Given the limited clinical data, an individualized risk stratification approach is essential. Shared decision-making, balancing religious aspirations with medical safety, is encouraged. Future studies are needed to establish evidence-based guidelines, but until then, thorough risk assessment, proactive monitoring, and patient education form the cornerstone of safe Ramadan fasting for individuals with hematological disorders.