Blood Transfusion Could Affect Surgical Outcomes in Cancer Patients

A new study suggests that the use of fresh red blood cells (RBCs) in transfusions for cancer patients could reduce cancer recurrence and improves long-term survival rates.

Researchers from Tel Aviv University (Israel) used rat models of leukemia and mammary adenocarcinoma to help determine whether blood transfusion is an independent risk factor for cancer recurrence and progression, and to understand what aspects of the transfusion cause the alleged harmful effects. Outcomes included host ability to clear circulating cancer cells and host survival rates. The independent impact of blood transfusion was assessed, and potential deleterious characteristics of the transfusion were studied, including blood storage duration; the role of erythrocytes, leukocyte, and soluble factors; and the kinetics of the effects.

The results of the study indicated that blood transfusion was an independent risk factor for cancer recurrence in the animal models used, causing up to a fourfold increase in lung tumor retention and doubling mortality rates. However, the study also yielded two surprising findings. First, the storage time of the transfused blood was the critical determinant of harmful effects, with fresh blood presenting no such effects. Secondly, and even more surprising, was that it was RBCs, and not white blood cells (WBCs), that caused the effects observed. The researchers also found a correlation between harmful effects of transfused blood and the amount of time it was stored, with the effects being most significant at nine days storage time or longer. There appeared to be no difference in harmful effects between transfused blood taken from the same animal or from a different animal. The study was published in the December 2008 issue of Anesthesiology.

"The current common approach in cancer patients is to use transfused blood depleted of white blood cells," said lead author Shamgar Ben-Eliyahu, Ph.D. of the neuroimmunology research unit. "But we found that removal of white blood cells was ineffective in our setting. Rather, we suggest a different approach: the use of fresh red blood cells for cancer surgeries. For the first time, we have shown in animal models that donor red blood cells, rather than white blood cells or other blood components, can be a critical factor in how blood transfusions affect cancer."

Related Links:
Tel Aviv University