Blood Transfusions and Prognosis in Colorectal Cancer: Long-Term Results of a Randomized Controlled Trial

@article{Harlaar2012BloodTA,
  title={Blood Transfusions and Prognosis in Colorectal Cancer: Long-Term Results of a Randomized Controlled Trial},
  author={J J Harlaar and Martijn P. Gosselink and Wim C. J. Hop and Johan F. Lange and Olivier R. C. Busch and Hans J Jeekel},
  journal={Annals of Surgery},
  year={2012},
  volume={256},
  pages={681–687}
}
Objective:Perioperative blood transfusions may adversely affect survival in patients with colorectal malignancy, although definite proof of a causal relationship has never been reported. Background:We report the long-term outcomes of a randomized controlled trial performed between 1986 and 1991 to compare the effects of allogeneic blood transfusions and an autologous blood transfusion program in colorectal cancer patients. Methods:All 475 randomized patients operated upon for colorectal cancer… 

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The blood transfusion modality has a significant effect on tumor recurrence after surgical treatment of colorectal cancer and might thus potentially surpass the impact of any recent adjuvant treatment strategies.

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Data suggests that an Hb of below 11 g/dl contributes to and is an indicator for a poor prognosis, and pre-treatment Hb corrections may significantly improve outcome, but further investigations, including blood transfusion/application of erythropoietin due to tumor anemia, independent of intraoperative blood-loss are necessary.

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The hypothesis that autologous blood transfusion does not contain immunologically neutral effects of allogeneic blood, but itself exerts an immunomodulatory effect is supported.