title: Allogeneic blood transfusion given before radiotherapy is associated with the poor clinical outcome in patients with cervical cancer.
abstract: OBJECTIVE
  To analyze the effect of allogeneic blood transfusion on clinical outcome in 119 patients with stage IIB cervical cancer who were treated with radiotherapy +/- chemotherapy.
  
  
  METHODS
  Medical records were examined for hemoglobin levels before and during radiotherapy, history of allogeneic blood transfusions and the time point when transfusions were given. These factors were retrospectively analyzed along with other clinical risk factors for influences on the patients' clinical outcomes.
  
  
  RESULTS
  Thirty-two patients (26.9%) received packed red blood cell transfusion (mean, 3.4 units; range, 1-12 units) before or during radiotherapy. Median follow-up period was 39.3 months (range, 7.6-58.4 months). Patients with history of transfusion showed poorer metastasis-free survival and a trend toward poorer overall survival than non-transfused patients. When patients who received transfusions were sub-divided by the time of transfusion, those who received transfusions before radiotherapy had significantly poorer clinical outcome than those who received transfusions during radiotherapy. In a multivariable analysis, patients with pretreatment transfusion showed a higher risk of distant metastasis (HR = 3.75, 95% CI: 1.28-12.15, p = 0.017) and decreased overall survival rates (HR = 4.62, 95% CI: 1.15-18.54, p = 0.031) compared with those of other patients.
  
  
  CONCLUSIONS
  Our results suggest that allogeneic blood transfusions given before radiotherapy may be associated with higher incidence of distant metastases and decreased survival in patients with stage IIB cervical cancer.
authors.affiliation: Research Institute and Hospital, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 410-769, Korea.
authors.forename: Myong Cheol
authors.initials: MC
authors.lastname: Lim
authors.forename: Joo-Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Kim
authors.forename: Sohee
authors.initials: S
authors.lastname: Park
authors.forename: Sun-Young
authors.initials: SY
authors.lastname: Kong
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Yoon
authors.forename: Sokbom
authors.initials: S
authors.lastname: Kang
authors.forename: Sang-Soo
authors.initials: SS
authors.lastname: Seo
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000532:radiotherapy / Q000556:secondary / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D065227:Transfusion Reaction; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000628:therapy*; D055815:Young Adult