Durham Veterans Affairs Medical Center and Duke University School of Medicine, 508 Fulton Street, Durham, NC 27705, USA.
Med Hypotheses. 2010 Apr;74(4):629-30. doi: 10.1016/j.mehy.2009.11.016. Epub 2009 Dec 21.
Red blood cells from patients with sickle cell disease will sickle under conditions of hypoxemia and acidosis which is a similar milieu found in malignant tumors. While control of tumor angiogenesis has long been a goal of cancer therapy, selective occlusion of tumor blood supply may be achieved by transfusion of sickle cells into patients who suffer metastatic cancer. Although this potential therapy has not been previously reported in the medical literature, the concept may have been elusive to medical mainstream thinking because it requires transfusion of diseased cells. For this therapy to be effective, other environmental factors may need to be manipulated such inducing mild hypoxemia or hypercarbia (respiratory acidosis) to induce red cell sickling. Preliminary evidence supportive of this therapeutic approach to cancer treatment is provided by case evidence that sickle cell occlusion of a malignant brain tumor (glioma) produced tumor necrosis. Also sickle cells have been successfully transfused into primates. Furthermore, donor blood is crossmatched and transfused into patients suffering from sickle cell disease regularly in clinics and this procedure is associated with acceptable morbidity. Most importantly, animal models of sickle cell disease and cancer currently exist, and this theory could be tried with available technologies including ultrasound detection of vaso-occlusion. While the proposed therapy may not cure metastatic cancer, this treatment could prove useful for decreasing the size and perhaps the pain from metastatic tumor burden. Therefore, it is hypothesized that ABO Rh compatible crossmatched sickle cells transfused into patients who suffer metastatic cancer under controlled conditions of blood oxygenation and pH will selectively produce vaso-occlusive infarcts in malignant tumors and be a useful therapy. The author hopes for further investigations.
镰状细胞病患者的红细胞在低氧血症和酸中毒条件下会发生镰变，而恶性肿瘤中也存在类似的环境。虽然控制肿瘤血管生成一直是癌症治疗的目标，但通过将镰状细胞输注到患有转移性癌症的患者中，可以选择性地阻塞肿瘤的血液供应。尽管这种潜在的治疗方法以前并未在医学文献中报道过，但由于它需要输注患病细胞，因此可能被医学主流思维所忽视。为了使这种治疗方法有效，可能需要操纵其他环境因素，例如诱导轻度低氧血症或高碳酸血症（呼吸性酸中毒）以诱导红细胞镰变。这种癌症治疗的治疗方法提供了初步的证据支持，即镰状细胞阻塞恶性脑瘤（神经胶质瘤）导致肿瘤坏死的病例证据。此外，已经成功地将镰状细胞输注到灵长类动物中。此外，在诊所中，经常对患有镰状细胞病的患者进行供体血液交叉配型和输注，并且该过程与可接受的发病率相关。最重要的是，目前存在镰状细胞病和癌症的动物模型，并且可以使用现有的技术（包括超声检测血管阻塞）来尝试该理论。虽然所提出的治疗方法可能无法治愈转移性癌症，但这种治疗方法可能有助于减小转移性肿瘤负担的大小，并可能减轻其疼痛。因此，假设在受控的血氧和 pH 条件下将 ABO Rh 相容的交叉配型镰状细胞输注到患有转移性癌症的患者中，将选择性地在恶性肿瘤中产生血管阻塞性梗塞，并成为一种有用的治疗方法。作者希望进一步调查。
