Blumberg N, Heal J M
Blood Bank, Strong Memorial Hospital, Rochester, New York.
Cancer Invest. 1987;5(6):615-25. doi: 10.3109/07357908709020321.
Evidence regarding the association of blood transfusions with recurrence of solid tumors is largely conflicting. This is perhaps not surprising given the retrospective nature of the studies, the complexity of the disease and its treatment, and variations in local transfusion practices. Nonetheless, data demonstrating that transfusions of whole blood are associated with earlier cancer recurrence are most readily explained by a cause and effect relationship. There is a growing literature documenting previously unforeseen immunologic consequences of homologous blood transfusion. These possible clinical consequences may include earlier cancer recurrence, and increased susceptibility to infection with bacteria and viruses. The questions raised in this review will likely be answered by further studies. For the present, the prudent clinician will select red blood cells rather than whole blood for transfusion, and recognize that blood transfusion is a therapy with considerable benefits, but also considerable risks.
关于输血与实体瘤复发之间关联的证据大多相互矛盾。鉴于这些研究的回顾性性质、疾病及其治疗的复杂性以及当地输血实践的差异，这或许并不令人惊讶。尽管如此，表明全血输血与癌症早期复发相关的数据最容易用因果关系来解释。越来越多的文献记录了同源输血此前未被预见的免疫后果。这些可能的临床后果包括癌症早期复发以及对细菌和病毒感染的易感性增加。本综述中提出的问题可能会通过进一步的研究得到解答。目前，谨慎的临床医生会选择红细胞而非全血进行输血，并认识到输血是一种益处可观但风险也相当大的治疗方法。
