The Effects of Perioperative Transfusion of Allogenic Blood Products of Cancer Recurrence

Abstract

Persons undergoing cancer resection surgeries often receive perioperative blood transfusions (PBT) to correct underlying anemia and optimize patient outcomes, namely post-surgical survival. However, there exists a host of emerging evidence suggesting that PBT may drive cancer recurrence and lower long-term disease-free survival. The prevailing theory for this phenomenon suggests that transfusion related immunomodulation (TRIM) downregulates immunogenic machinery in the transfusion recipient and facilitates the production of an oncogenic host environment. Notably, there also exist some studies suggesting that clinical parameters – ranging from cancer severity to performance status – may be ultimately more responsible than PBT in mediating cancer recurrence risk. A clear understanding of PBT induced cancer recurrence has yet to be clearly elucidated. Regardless of the precise molecular mechanisms, judicious transfusion practices are necessary to optimize patient safety profiles and long-term disease-free survival. Unfortunately, this concern of PBT conferred cancer recurrence is still novel and further studies exploring underlying mechanisms, such as TRIM, and directing clinical practice patterns for PBT usage are necessary.