Transfusion-induced immunosuppression results in diminished host survival in a murine neuroblastoma model

Perioperative blood transfusion has been associated with decreased survival in cancer patients. The immunologic consequences of H-2 incompatible blood transfusion as related to neoplasia are unclear. This report examined the effect of multiple allogeneic blood transfusions, compared to syngeneic transfusions and saline infusion, on cellular immunity, tumor growth, and host survival in a murine C1300 neuroblastoma model. A/J mice were randomized to receive two weekly transfusions of washed whole blood cells from C57 Bl/6 or A/J donors or saline. Animals transfused with allogeneic blood, compared to syngeneic transfusions or saline infusions, had a significantly diminished lymphocyte response to mitogen (P less than 0.001), reduced donor-specific (P less than 0.001) and third party alloantigen (P less than 0.01) MLR, and reduced cytotoxicity against a natural killer (NK) cell-sensitive target (P less than 0.001). These in vitro deficits in cellular immunity correlated with a significantly greater Day 21 tumor weight to total body weight ratio in the allogeneic group (0.33) compared with the syngeneic (0.25) and saline (0.28) groups P less than 0.05). Median host survival was reduced in the allogeneic group (24 days) compared with the syngeneic (30 days) and saline (31 days) groups. There were no significant differences in cellular immunity, tumor growth, or survival between syngeneic and saline control groups. Allogeneic blood transfusion had an adverse affect on NK and T-lymphocyte function which was associated with enhanced tumor growth and reduced survival in tumor-bearing mice.