Abstract
BackgroundIntra-operative cell salvage (IOCS) and leukocyte-depleted filter (LDF) are widely used and effective in saving blood. However, the safety issue concerning reinfusion of IOCS–LDF processed blood to renal cell carcinoma (RCC) patients with inferior vena cava (IVC) thrombus were inconclusive for fear of increased risk of cancer metastases. This study intends to analyze the circulating tumor cell (CTC) eliminating effect of IOCS–LDF in 5 RCC–IVC thrombus patients.MethodsA novel strategy integrating negative enrichment by immunomagnetic beads and immunostaining-fluorescence in situ hybridization with probes identifying aneuploid of 8 and/or 7 were used to detect CTCs from salvages blood. Blood samples were collected from 4 stages in each patient.ResultsOf the 5 RCC patients, the number of CTCs decreased (from 3, 4, 10, 7, 3, respectively, to all zero) after IOCS–LDF treatment. The triploid of chromosome 7 and/or chromosome 8 were most common karyotype for RCC patients with IVC thrombus. Tetraploid of chromosome 8 occurred in only one sample and no polypoid (number of chromosome > 4) were found.ConclusionIOCS–LDF might be a promising way of reducing of allogeneic product transfusion based on current preliminary outcome. More convincing conclusions are to be drawn with enlarged sample size and long-term follow-up for patients prognosis.
Highlights
Intra-operative cell salvage (IOCS) and leukocyte-depleted filter (LDF) are widely used and effective in saving blood
Demographic information In the current study, a total of 5 patients with renal cell carcinoma (RCC)– inferior vena cava (IVC) thrombus were included for surgical treatment
We demonstrated with NE-iFISH method, all the tumor cells in 5 patients were completely removed after LDF treatment, and intraoperative IOCS–LDF usage could clear all tumor cells in RCC–IVC thrombus patients with high efficiency
Summary
Intra-operative cell salvage (IOCS) and leukocyte-depleted filter (LDF) are widely used and effective in saving blood. The safety issue concerning reinfusion of IOCS–LDF processed blood to renal cell carcinoma (RCC) patients with inferior vena cava (IVC) thrombus were inconclusive for fear of increased risk of cancer metastases. Renal cell carcinoma (RCC) ranks the sixth most frequently diagnosed cancer in men and the 10th in women worldwide. It is the 13th most common cause of cancer. Zhang et al BMC Urol (2021) 21:89 It is observed in 4–10% RCC patients who have a unique propensity for vascular invasion (into the renal vein and inferior vena cava) in the advanced stage [2]. Patients with RCC–IVC tumor thrombus had a significant blood loss during operation despite improvements in surgical technique. It is concerned that allogeneic transfusion may result in immunosuppression and possible adverse effects on urological cancer recurrence [7,8,9]
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