Allogeneic versus autologous blood transfusion and survival after radical prostatectomy (CME)

Background Potential adverse effects of blood transfusion (BT) remain controversial, especially for clinical outcomes after curative cancer surgery. Some postulate that immune modulation after allogeneic BT predisposes to recurrence and death, but autologous superiority is not established. This stud...

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Published in:Transfusion (Philadelphia, Pa.) Pa.), 2014-09, Vol.54 (9), p.2168-2174
Main Authors: Chalfin, Heather J., Frank, Steven M., Feng, Zhaoyong, Trock, Bruce J., Drake, Charles G., Partin, Alan W., Humphreys, Elizabeth, Ness, Paul M., Jeong, Byong C., Lee, Seung B., Han, Misop
Format: Article
Language:English
Subjects:
Adult
Aged
Blood
Blood Transfusion, Autologous - adverse effects
Blood transfusions
Cancer
Humans
Male
Medical research
Middle Aged
Proportional Hazards Models
Prostatectomy - methods
Prostatic Neoplasms - mortality
Prostatic Neoplasms - surgery
Transplantation, Homologous - adverse effects
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Summary:Background Potential adverse effects of blood transfusion (BT) remain controversial, especially for clinical outcomes after curative cancer surgery. Some postulate that immune modulation after allogeneic BT predisposes to recurrence and death, but autologous superiority is not established. This study assessed whether BT is associated with long‐term prostate cancer recurrence and survival with a large single‐institutional radical prostatectomy (RP) database. Study Design and Methods Between 1994 and 2012, a total of 11,680 patients had RP with available outcome and transfusion data. A total of 7443 (64%) had complete covariate data. Clinical variables associated with biochemical recurrence‐free survival (BRFS), cancer‐specific survival (CSS), and overall survival (OS) were identified with Cox proportional hazards models for three groups: no BT (reference, 27.7%, n = 2061), autologous BT only (68.8%, n = 5124), and any allogeneic BT (with or without autologous, 3.5%, n = 258). Results Median (range) follow‐up was 6 (1‐18) years. Kaplan‐Meier analysis showed significantly decreased OS (but not BRFS or PCSS) in the allogeneic group versus autologous and no BT groups (p = 0.006). With univariate analysis, any allogeneic BT had a hazard ratio (HR) of 2.29 (range, 1.52‐3.46; p 
ISSN:0041-1132
1537-2995
DOI:10.1111/trf.12611