Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan;12(2):1237-1246.
doi: 10.1002/cam4.4989. Epub 2022 Jun 28.

Impact of allogeneic red blood cell transfusion on prognosis in soft tissue sarcoma patients. A single-centre study

Maria Anna Smolle  1 , Wolfgang Helmberg  2 , Eva Maria Matzhold  2 , Dominik Andreas Barth  3 , Nazanin Sareban  2 , Joanna Szkandera  3 , Bernadette Liegl-Atzwanger  4 , Andreas Leithner  1 , Martin Pichler  3
Affiliations

Impact of allogeneic red blood cell transfusion on prognosis in soft tissue sarcoma patients. A single-centre study

Maria Anna Smolle et al. Cancer Med. 2023 Jan.

Abstract

Background: Perioperatively administered (leukocyte reduced) allogeneic red blood cell transfusions (lrRBCTs) may lead to transfusion-related immunomodulation and reduced overall survival (OS) in cancer patients. Herein, the effect of lrRBCT on local recurrence (LR), distant metastasis (DM), and OS in soft tissue sarcoma (STS) patients was analysed.

Methods: Retrospective study on 432 STS patients (mean age: 60.0 ± 17.8 years; 46.1% female), surgically treated at a tertiary tumour centre. Uni- and multivariate survival models were calculated to analyse impact of perioperative lrRBCTs on LR, DM, OS.

Results: Perioperatively, 75 patients (17.4%) had received lrRBCTs. Older patients, deep, large, lower limb STS rather required lrRBCTs (all p < 0.05). No significant association between lrRBCT administration and LR- (p = 0.582) or DM-risk (p = 0.084) was observed. LrRBCT was associated with worse OS in univariate analysis (HR: 2.222; p < 0.001), with statistical significance lost upon multivariate analysis (HR: 1.658; p = 0.059; including age, histology, size, grading, amputation, depth). Adding preoperative haemoglobin in subgroup of 220 patients with laboratory parameters revealed significant negative impact of low haemoglobin on OS (p = 0.014), whilst effect of lrRBCT was further diminished (p = 0.167).

Conclusion: Unfavourable prognostic factors prevail in STS patients requiring lrRBCTs. Low haemoglobin levels rather than lrRBCT seem to reduce OS.

Keywords: prognosis; soft tissue sarcoma; surgery; surgical oncology.

PubMed Disclaimer

Conflict of interest statement

None of the authors has any conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Significant negative impact of lrRBCT transfusion on patient overall survival in the univariate analysis (A), but not in the multivariate analysis (B).
See this image and copyright information in PMC

References

    1. Fischer D, Neb H, Choorapoikayil S, Zacharowski K, Meybohm P. Red blood cell transfusion and its alternatives in oncologic surgery‐a critical evaluation. Crit Rev Oncol Hematol. 2019;134:1‐9. - PubMed
    1. Ludwig H, Van Belle S, Barrett‐Lee P, et al. The European cancer Anaemia survey (ECAS): a large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. Eur J Cancer. 2004;40(15):2293‐2306. - PubMed
    1. Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer. 2001;91(12):2214‐2221. - PubMed
    1. Glaspy J. Anemia and fatigue in cancer patients. Cancer. 2001;92(6 Suppl):1719‐1724. - PubMed
    1. Szkandera J, Gerger A, Liegl‐Atzwanger B, et al. Pre‐treatment anemia is a poor prognostic factor in soft tissue sarcoma patients. PLoS One. 2014;9(9):e107297. - PMC - PubMed