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Blood Transfusion and Cancer: Modulation or Tolerance?

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Immunology and Blood Transfusion

Part of the book series: Developments in Hematology and Immunology ((DIHI,volume 28))

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Abstract

The concept of immunosurveillance has evoked a wide spread interest in the role of the immune system in the natural history of cancer. Clinical data from immunodeficient [1] and immunosuppressed [2] patients show an increased incidence of malignancy. Blood transfusions (BT) have diverse immunomodulating effects. For instance, pre-transplant random-donor BT diminish the incidence of renal allograft rejection [3,4] and can give rise to leukocyte antibodies [5]. Several essential factors and clues for the mechanisms of this BT induced immunosuppression in allograft transplantation have recently been elucidated, but the precise mechanism(s) remains unclear. Combining these observed phenomena Gantt raised the question whether immunomodulating effects of peri-operative blood transfusion might adversely affect the prognosis of cancer patients [6]. Surgical resection of tumours often requires blood transfusion. In case of a curative operation, the primary tumour is removed, but nevertheless a percentage of the patients will develop distant metastases [7]. Minimal residual disease in the form of undetectable micrometastases and/or tumour cells spilled in the operation region or into the circulation during surgery might be explanations for these observations. However, not all patients having a similar cancer stage show recurrence of the tumour. Probably minimal residual disease not always results in cancer recurrence. It is suggested that besides tumour characteristics and genetics the immune defense might play a role in the outgrowth of micrometastases. Before addressing possible mechanisms the relationship between blood transfusion and cancer prognosis has to be clarified on a clinical level (the horizontal arrow in (Figure 1).

This work was partially supported by the Praeventiefonds and the Macropa Foundation.

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Authors and Affiliations

  1. Department of Immunohaematology & Blood Bank, University Hospital Leiden, The Netherlands

    J. G. A. Houbiers, L. M. G. van de Watering & A. Brand

  2. Department of Surgery, University Hospital Leiden, The Netherlands

    J. G. A. Houbiers & C. J. H. van de Velde

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  1. J. G. A. Houbiers
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  2. L. M. G. van de Watering
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  3. C. J. H. van de Velde
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  4. A. Brand
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Editors and Affiliations

  1. Red Cross Blood Bank Groningen-Drenthe, The Netherlands

    C. Th. Smit Sibinga  & P. C. Das  & 

  2. University of Groningen, The Netherlands

    T. H. The (Professor of Clinical Immunology) (Professor of Clinical Immunology)

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Houbiers, J.G.A., van de Watering, L.M.G., van de Velde, C.J.H., Brand, A. (1993). Blood Transfusion and Cancer: Modulation or Tolerance?. In: Sibinga, C.T.S., Das, P.C., The, T.H. (eds) Immunology and Blood Transfusion. Developments in Hematology and Immunology, vol 28. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3094-7_25

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  • DOI: https://doi.org/10.1007/978-1-4615-3094-7_25

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