Newswise — Among other findings, a study presented in the December issue of Anesthesiology suggests that the use of fresh red blood cells in transfusions for cancer patients could improve cancer recurrence and long-term survival rates.
Blood transfusion during certain cancer surgeries is associated with increased cancer recurrence and reduced survival rates. Why this happens is not well understood.
A study by Shamgar Ben-Eliyahu, Ph.D., and his research group from Tel Aviv University, however, offers unique and surprising insights that could open doors for important research in humans in the near future.
Dr. Ben-Eliyahu and his colleagues used rat models of leukemia and breast cancer to help determine whether blood transfusion is an independent risk factor for cancer recurrence/progression and to understand what aspects of the transfusion cause the alleged harmful effects.
"The results of our study clearly indicate that blood transfusion is an independent risk factor for cancer recurrence in the animal models we used," said Dr. Ben-Eliyahu. "But our study also yielded two surprising findings. First, the storage time of the transfused blood was the critical determinant of harmful effects: fresh blood had no harmful effects. Second, and even more surprising, we found that red blood cells, not white blood cells, caused the effects we observed."
It is commonly believed that white blood cells within transfused blood are responsible for known and alleged harmful effects of transfusion, but this belief was actually tested and not confirmed regarding cancer progression, said Dr. Ben-Eliyahu.
The group also found a correlation between harmful effects of transfused blood and the amount of time it was stored, with those 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, he said.
"The current common approach in cancer patients is to use transfused blood depleted of white blood cells," said Dr. Ben-Eliyahu. "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. "
Dr. Ben-Eliyahu said that the results of his study suggest the need for studies in cancer patients, including retrospective and prospective studies, to determine if alterations in blood transfusion practices can indeed improve patient outcomes.
Anesthesiologists: Physicians providing the lifeline of modern medicine. Founded in 1905, the American Society of Anesthesiologists is an educational, research and scientific association with 43,000 members organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.
For more information visit the ASA Web site at http://www.asahq.org.
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Anesthesiology, December 2008 (Dec-2008)
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