Analysis of peripheral blood for prostate cells after autologous transfusion given during radical prostatectomy.
OBJECTIVE
To determine if cells expressing prostate-specific antigen (PSA) can be detected in blood collected by a cell-saver during radical prostatectomy (RP) or in the peripheral blood after intraoperative autotransfusion (IAT).


METHODS
In all, 112 men with clinical T1c-T2 prostate cancer undergoing RP were prospectively assessed. A cell-saver system was used in each to collect blood from the surgical field after prostate manipulation. IAT was given based on clinical indications. Standardized peripheral blood samples were collected from patients before RP, in the recovery room afterward, and at 3-5 weeks after surgery. A reverse-transcriptase-polymerase chain reaction assay for PSA mRNA was used to detect prostate cells in cell-saver and peripheral blood samples. Patients were followed after surgery with PSA measurements to assess biochemical failure.


RESULTS
PSA-expressing cells were detected in 88% of cell-saver reservoir and 13% of preoperative blood samples. No PSA-expressing prostate cells were detected in any peripheral blood samples collected 3-5 weeks after surgery. Analysis of data with 40 months of follow-up showed IAT was not an independent predictor of biochemical failure in multivariate analysis.


CONCLUSIONS
Although IAT blood contains PSA-expressing cells, none could be detected 3-5 weeks after surgery. IAT during RP was not associated with a greater risk of biochemical failure.
Stoffel
John T
JT
Department of Urology, Lahey Clinic, Burlington, MA, USA. stoffelj7@yahoo.com
Topjian
Linda
L
Libertino
John A
JA
D001804:Blood Transfusion, Autologous; D006801:Humans; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D011300:Preoperative Care / Q000379:methods; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery
D017430:Prostate-Specific Antigen