Blood transfusions and phenotypic immune profile in head and neck cancer patients undergoing surgical resection

Recent papers in the general surgery and otolaryngology literature have shown a positive correlation between blood transfusion and decreased survival in cancer patients. This is felt to be due to immunosuppression (not yet defined) induced by the transfusion. We prospectively analyzed the peripheral blood immune profiles of patients undergoing surgery for control of their squamous cell carcinoma of the upper aerodigestive tract. Pre- and postoperative profiles were examined. T4, T8, natural killer cells, and interleukin 2 receptor-positive T cell subsets were analyzed by flow cytometry. Statistical analysis indicated a significant difference between the non-transfused and transfused subgroups, with the transfused group having a decrease in their T helper cell and interleukin 2 receptor positive helper cell populations. This supports other literature which shows an increased recurrence rate in the transfused patient population. The patients were analyzed comparing blood transfusions, immune status, initial stage of disease, the nodal status of the disease, tumor differentiation, and patient's age yielding transfusion as the greatest single contributing factor to the observed immunological changes.