Do Blood Transfusions Affect Survival in Colorectal Cancer?
Harlaar JJ, Gosselink MP, Hop WC, Lange JF, Busch OR, Jeekel H
Ann Surg. 2012;256:681-686
What is the impact of blood transfusion on survival after colorectal cancer surgery? The authors reported results after 20 years of follow-up in 475 patients who received either an allogeneic or autologous transfusion of blood. In the autologous group, 20-year survival was 21%, compared with a survival rate of 28% in the allogeneic group (P = .041). The results were similar for overall survival and for colorectal cancer-specific survival. Patients in the autologous group who never needed an operative or postoperative reinfusion of blood had a worse prognosis than patients in the autologous group who were not transfused (P = .004).
The original results of this study were first reported in 1993. At that time, with limited follow-up, no survival difference was found between patients in the autologous or allogeneic groups. Remarkably, after 20 years, the authors achieved a follow-up rate of 94% of the original group and found that with longer follow-up, autologous transfusion is detrimental. They also found no survival differences in patients receiving or not receiving blood in either group. They speculated that anoxia resulting from blood donation may have had an impact on survival. This report weakens the widely held belief that allogeneic blood transfusions increase the risk for cancer recurrence by weakening the immune system.
Abstract
Blood Transfusions and Prognosis in Colorectal Cancer: Long-term Results of a Randomized Controlled Trial
Harlaar JJ, Gosselink MP, Hop WC, Lange JF, Busch OR, Jeekel H
Ann Surg. 2012;256:681-686
Summary
What is the impact of blood transfusion on survival after colorectal cancer surgery? The authors reported results after 20 years of follow-up in 475 patients who received either an allogeneic or autologous transfusion of blood. In the autologous group, 20-year survival was 21%, compared with a survival rate of 28% in the allogeneic group (P = .041). The results were similar for overall survival and for colorectal cancer-specific survival. Patients in the autologous group who never needed an operative or postoperative reinfusion of blood had a worse prognosis than patients in the autologous group who were not transfused (P = .004).
Viewpoint
The original results of this study were first reported in 1993. At that time, with limited follow-up, no survival difference was found between patients in the autologous or allogeneic groups. Remarkably, after 20 years, the authors achieved a follow-up rate of 94% of the original group and found that with longer follow-up, autologous transfusion is detrimental. They also found no survival differences in patients receiving or not receiving blood in either group. They speculated that anoxia resulting from blood donation may have had an impact on survival. This report weakens the widely held belief that allogeneic blood transfusions increase the risk for cancer recurrence by weakening the immune system.
Abstract
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