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Review
. 2021 Apr;14(4):101022.
doi: 10.1016/j.tranon.2021.101022. Epub 2021 Feb 2.

Platelet transfusion for cancer secondary thrombocytopenia: Platelet and cancer cell interaction

Juan Wang  1 , Pan Zhou  2 , Yunwei Han  3 , Hongwei Zhang  4
Affiliations
Review

Platelet transfusion for cancer secondary thrombocytopenia: Platelet and cancer cell interaction

Juan Wang et al. Transl Oncol. 2021 Apr.

Abstract

Chemoradiotherapy and autoimmune disorder often lead to secondary thrombocytopenia in cancer patients, and thus, platelet transfusion is needed to stop or prevent bleeding. However, the effect of platelet transfusion remains controversial for the lack of agreement on transfusion strategies. Before being transfused, platelets are stored in blood banks, and their activation is usually stimulated. Increasing evidence shows activated platelets may promote metastasis and the proliferation of cancer cells, while cancer cells also induce platelet activation. Such a vicious cycle of interaction between activated platelets and cancer cells is harmful for the prognosis of cancer patients, which results in an increased tumor recurrence rate and decreased five-year survival rate. Therefore, it is important to explore platelet transfusion strategies, summarize mechanisms of interaction between platelets and tumor cells, and carefully evaluate the pros and cons of platelet transfusion for better treatment and prognosis for patients with cancer with secondary thrombocytopenia.

Keywords: Blood transfusion; Cancer cells; Cancer secondary thrombocytopenia; Platelets.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image, graphical abstract
Graphical abstract
Fig 1
Fig. 1
Platelets promote metastasis of tumor cells to form a “positive feedback loop” in circulation.
Fig 2
Fig. 2
Biological effects of tumor cells mediated by platelet activation.
Fig 3
Fig. 3
Platelets help tumor cells escape from immune surveillance.
Fig 4
Fig. 4
Vesicles activate platelets to promote tumor cell metastasis and blood vessels. angiogenesis: A. Extracellular vesicles of tumor cells activate platelets indirectly or directly; B. Activated platelets further promote tumor cell growth and platelet-derived extracellular vesicles promote tumor angiogenesis; C. Heterotypic platelet tumor cell aggregates promote migration and spillover of cancer cells. TF and PMP expressed in tumor cells can strengthen the procoagulant environment generated by the interaction of platelets and cancer cells, produce thrombin, activate platelets, form thromboembolism, block blood vessels while they increase endothelial permeability; and D. Platelets promote tumorigenesis, growth, and distant metastasis.
Fig 5
Fig. 5
Signaling pathway of platelet-promoting tumor metastasis.
See this image and copyright information in PMC

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