Immune modulation and microchimerism after unmodified versus leukoreduced allogeneic red blood cell transfusion in cancer patients: results of a randomized study.

Abstract

BACKGROUND:

Transfusion of red blood cells (RBCs) has been associated with immunomodulatory effects. Persistence of donor cells in the recipient may be contributive.

STUDY DESIGN AND METHODS:

A randomized single-center trial was conducted to compare microchimerism and immune responses in 35 patients undergoing cancer surgery and transfused perioperatively with either unmodified RBCs (UN-RBCs, n = 18) or leukoreduced RBCs (LR-RBCs, n = 17). Biologic parameters included microchimerism assessment peripheral blood mononuclear cell (PBMNC) phenotyping, cytokine production by stimulated PBMNCs, FoxP3 gene expression, and T-cell repertoire (TCR) analysis.

RESULTS:

Microchimerism was documented in 8 of 18 patients after UN-RBC transfusion while absent after LR-RBC transfusion (0/17; p = 0.001). After UN-RBC transfusion, microchimerism was associated with increased interleukin (IL)-10 production (p = 0.02), reduced TCR alteration (p = 0.04), and reduced CD56+ cell counts (p = 0.02) when compared to recipients without evidence for microchimerism. FoxP3 gene expression did not differ significantly between both treatment groups nor with the presence or absence of microchimerism in the UN-RBC group. Finally, after an initial early decrease after surgery and transfusion, IL-12 production increased and more significantly so after UN-RBC transfusion versus LR-RBC transfusion (p = 0.05).

CONCLUSION:

UN-RBC-induced microchimerism is associated with specific immunomodulatory effects in cancer patients who received transfusions during surgery.

• Authors: Valérie Lapierre, Anne Aupérin, Eric Robinet, Christophe Ferrand, Nadia Oubouzar, Dominique Tramalloni, Philippe Saas, Bertrand Debaene, Philippe Lasser, Pierre Tiberghien
• Journal: Transfusion (Transfusion) Vol. 47 Issue 9 Pg. 1691-9 (Sep 2007) ISSN: 0041-1132 [Print] United States
• PMID: 17725736 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Cytokines
• FOXP3 protein, human
• Forkhead Transcription Factors

Topics

• Adult
• Aged
• Blood Transfusion, Autologous
• Chimerism
• Cytokines (biosynthesis)
• Erythrocyte Transfusion (adverse effects)
• Erythrocytes (metabolism)
• Female
• Follow-Up Studies
• Forkhead Transcription Factors (metabolism)
• Humans
• Immune Tolerance (immunology)
• Leukocytes (immunology)
• Male
• Middle Aged
• Neoplasms (immunology, surgery)
• Phenotype
• Survival Rate