Blood transfusion is a vital and lifesaving intervention in a broad range of scenarios, from trauma response to cancer treatment. However, it is not entirely without risk.
Recently published research found that blood transfusion is associated with adverse outcomes — including infection and higher rates of tumor recurrence — in pediatric solid tumor oncology patients following surgical removal of the tumor.
“Blood transfusion is obviously hugely important when used in the appropriate clinical scenario, but there are some downsides,” says study author Shannon Acker, MD, an assistant professor of pediatric surgery in the University of Colorado School of Medicine. “It’s pro-inflammatory and suppresses the immune system because your body reacts to foreign tissue. It can be a vital intervention, but I think we’re starting to be a little more thoughtful about giving patients blood products.”
Understanding pediatric blood transfusion
Acker and her co-researchers pursued this research, in part, because while the effects of packed red blood cell (PRBC) transfusion in adult populations have been widely studied, data are sparser for pediatric patients.
“It’s fairly well-documented that in adult patients, perioperative blood transfusion for solid tumor resection is associated with certain adverse outcomes,” Acker explains. “But pediatric cancers are more rare, so they’re more challenging to study. We need more data to understand whether what we know to be true in adult cancers is also true in pediatric cancers.”
Drawing retrospective data from Children’s Hospital Colorado pediatric patients over 11 years, Acker and her co-researchers included malignant solid tumors removed by surgeons across all surgical disciplines. Acker acknowledges that grouping different types of cancer into one study lessens the validity of the research because different cancers have different outcomes, “but we needed a place to start so we can begin working toward more collaborative, multi-center pediatric oncology research,” she says.
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