Skip to main content
The Yale Journal of Biology and Medicine logoLink to The Yale Journal of Biology and Medicine
. 1990 Sep-Oct;63(5):429–433.

Transfusion-induced immunomodulation and its possible role in cancer recurrence and perioperative bacterial infection.

N Blumberg 1, J M Heal 1
PMCID: PMC2589357  PMID: 2293502

Abstract

Over the last decade, it has become evident that homologous transfusions carry immunologic consequences beyond the well-understood ones of alloimmunization to blood cell antigens. Transfusions constitute temporary transplants of large amounts of allogeneic antigen given intravenously and cause down-regulation of many cellular immune functions. These changes may explain in part the association of transfusion with such clinically important events as (1) improved survival of renal allografts, (2) decreased recurrence rates for autoimmune disease, (3) increased frequency and earlier recurrences of solid tumors, (4) increased frequency of post-operative bacterial infection, and (5) increased severity of viral infection. Preliminary data suggest that, in animal models and clinical settings, syngeneic or autologous transfusions are not associated with such events. This finding supports the hypothesis that these associations are cause and effect and involve immunologic mechanisms.

Full text

PDF
429

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blumberg N., Chuang-Stein C., Heal J. M. The relationship of blood transfusion, tumor staging, and cancer recurrence. Transfusion. 1990 May;30(4):291–294. doi: 10.1046/j.1537-2995.1990.30490273432.x. [DOI] [PubMed] [Google Scholar]
  2. Blumberg N., Heal J. M. Evidence for plasma-mediated immunomodulation--transfusions of plasma-rich blood components are associated with a greater risk of acquired immunodeficiency syndrome than transfusions of red blood cells alone. Transplant Proc. 1988 Dec;20(6):1138–1142. [PubMed] [Google Scholar]
  3. Blumberg N., Heal J. M. Perioperative blood transfusion and solid tumor recurrence--a review. Cancer Invest. 1987;5(6):615–625. doi: 10.3109/07357908709020321. [DOI] [PubMed] [Google Scholar]
  4. Blumberg N., Heal J. M. Transfusion and host defenses against cancer recurrence and infection. Transfusion. 1989 Mar-Apr;29(3):236–245. doi: 10.1046/j.1537-2995.1989.29389162731.x. [DOI] [PubMed] [Google Scholar]
  5. Blumberg N., Heal J. M. Transfusion and recipient immune function. Arch Pathol Lab Med. 1989 Mar;113(3):246–253. [PubMed] [Google Scholar]
  6. Blumberg N., Heal J., Chuang C., Murphy P., Agarwal M. Further evidence supporting a cause and effect relationship between blood transfusion and earlier cancer recurrence. Ann Surg. 1988 Apr;207(4):410–415. doi: 10.1097/00000658-198804000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. George C. D., Morello P. J. Immunologic effects of blood transfusion upon renal transplantation, tumor operations, and bacterial infections. Am J Surg. 1986 Sep;152(3):329–337. doi: 10.1016/0002-9610(86)90269-2. [DOI] [PubMed] [Google Scholar]
  8. Heal J. M., Chuang C., Blumberg N. Perioperative blood transfusions and prostate cancer recurrence and survival. Am J Surg. 1988 Nov;156(5):374–380. doi: 10.1016/s0002-9610(88)80190-9. [DOI] [PubMed] [Google Scholar]
  9. Hermanek P., Jr, Guggenmoos-Holzmann I., Schricker K. T., Resch T., Freudenberger K., Neidhardt P., Gall F. P. Der Einfluss der Transfusion von Blut und Haemoderivaten auf die Prognose des colorectalen Carcinoms. Langenbecks Arch Chir. 1989;374(2):118–124. doi: 10.1007/BF01261621. [DOI] [PubMed] [Google Scholar]
  10. Peters W. R., Fry R. D., Fleshman J. W., Kodner I. J. Multiple blood transfusions reduce the recurrence rate of Crohn's disease. Dis Colon Rectum. 1989 Sep;32(9):749–753. doi: 10.1007/BF02562122. [DOI] [PubMed] [Google Scholar]
  11. Preiksaitis J. K., Brown L., McKenzie M. The risk of cytomegalovirus infection in seronegative transfusion recipients not receiving exogenous immunosuppression. J Infect Dis. 1988 Mar;157(3):523–529. doi: 10.1093/infdis/157.3.523. [DOI] [PubMed] [Google Scholar]
  12. Schriemer P. A., Longnecker D. E., Mintz P. D. The possible immunosuppressive effects of perioperative blood transfusion in cancer patients. Anesthesiology. 1988 Mar;68(3):422–428. doi: 10.1097/00000542-198803000-00017. [DOI] [PubMed] [Google Scholar]
  13. Tartter P. I. Blood transfusion and infectious complications following colorectal cancer surgery. Br J Surg. 1988 Aug;75(8):789–792. doi: 10.1002/bjs.1800750822. [DOI] [PubMed] [Google Scholar]
  14. Tartter P. I. Blood transfusion and postoperative infections. Transfusion. 1989 Jun;29(5):456–459. doi: 10.1046/j.1537-2995.1989.29589284149.x. [DOI] [PubMed] [Google Scholar]
  15. Ward J. W., Bush T. J., Perkins H. A., Lieb L. E., Allen J. R., Goldfinger D., Samson S. M., Pepkowitz S. H., Fernando L. P., Holland P. V. The natural history of transfusion-associated infection with human immunodeficiency virus. Factors influencing the rate of progression to disease. N Engl J Med. 1989 Oct 5;321(14):947–952. doi: 10.1056/NEJM198910053211406. [DOI] [PubMed] [Google Scholar]
  16. Waymack J. P., Balakrishnan K., McNeal N., Gonce S., Miskell P., Warden G. D., Alexander J. W. Effect of blood transfusions on macrophage-lymphocyte interaction in an animal model. Ann Surg. 1986 Dec;204(6):681–685. doi: 10.1097/00000658-198612000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Waymack J. P., Miskell P., Gonce S. Alterations in host defense associated with inhalation anesthesia and blood transfusion. Anesth Analg. 1989 Aug;69(2):163–168. [PubMed] [Google Scholar]
  18. Williams J. G., Hughes L. E. Effect of perioperative blood transfusion on recurrence of Crohn's disease. Lancet. 1989 Jul 15;2(8655):131–133. doi: 10.1016/s0140-6736(89)90185-2. [DOI] [PubMed] [Google Scholar]
  19. Wobbes T., Joosen K. H., Kuypers H. H., Beerthuizen G. I., Theeuwes G. M. The effect of packed cells and whole blood transfusions on survival after curative resection for colorectal carcinoma. Dis Colon Rectum. 1989 Sep;32(9):743–748. doi: 10.1007/BF02562121. [DOI] [PubMed] [Google Scholar]

Articles from The Yale Journal of Biology and Medicine are provided here courtesy of Yale Journal of Biology and Medicine

RESOURCES