Transfusion of sickle cells may be a therapeutic option for patients suffering metastatic disease.
Red blood cells from patients with sickle cell disease will sickle under conditions of hypoxemia and acidosis which is a similar milieu found in malignant tumors. While control of tumor angiogenesis has long been a goal of cancer therapy, selective occlusion of tumor blood supply may be achieved by transfusion of sickle cells into patients who suffer metastatic cancer. Although this potential therapy has not been previously reported in the medical literature, the concept may have been elusive to medical mainstream thinking because it requires transfusion of diseased cells. For this therapy to be effective, other environmental factors may need to be manipulated such inducing mild hypoxemia or hypercarbia (respiratory acidosis) to induce red cell sickling. Preliminary evidence supportive of this therapeutic approach to cancer treatment is provided by case evidence that sickle cell occlusion of a malignant brain tumor (glioma) produced tumor necrosis. Also sickle cells have been successfully transfused into primates. Furthermore, donor blood is crossmatched and transfused into patients suffering from sickle cell disease regularly in clinics and this procedure is associated with acceptable morbidity. Most importantly, animal models of sickle cell disease and cancer currently exist, and this theory could be tried with available technologies including ultrasound detection of vaso-occlusion. While the proposed therapy may not cure metastatic cancer, this treatment could prove useful for decreasing the size and perhaps the pain from metastatic tumor burden. Therefore, it is hypothesized that ABO Rh compatible crossmatched sickle cells transfused into patients who suffer metastatic cancer under controlled conditions of blood oxygenation and pH will selectively produce vaso-occlusive infarcts in malignant tumors and be a useful therapy. The author hopes for further investigations.
Goldberg
Joel S
JS
Durham Veterans Affairs Medical Center and Duke University School of Medicine, 508 Fulton Street, Durham, NC 27705, USA. goldb002@mc.duke.edu
D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications / Q000628:therapy*; D001782:Blood Donors; D001803:Blood Transfusion / Q000379:methods*; D003625:Data Collection / Q000379:methods; D017707:Erythrocyte Transfusion / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010146:Pain / Q000209:etiology; D059408:Pain Management; D013315:Stress, Psychological / Q000628:therapy*; D065227:Transfusion Reaction