title: Perioperative allogeneic nonleukoreduced blood transfusion and prostate cancer outcomes after radical prostatectomy.
abstract: BACKGROUND
  Allogeneic blood transfusion induces immunosuppression, and concern has been raised that it may increase propensity for cancer recurrence; however, these effects have not been confirmed. We examined the association of perioperative transfusion of allogeneic blood long-term oncologic outcomes in patients with prostate cancer who underwent prostatectomy.
  
  
  METHODS
  We reviewed medical records of patients who underwent radical prostatectomy between 1991 and 2005 and received allogeneic nonleukoreduced blood. Each transfused patient was matched to two controls who did not receive blood: matching included age, surgical year, prostate-specific antigen level, pathologic tumor stages, pathologic Gleason scores, and anesthetic type. Primary outcome was systemic tumor progression, with secondary outcomes of prostate cancer death and all-cause mortality. Stratified proportional hazards regression analysis was used to assess differences in outcomes between the transfused and nontransfused group.
  
  
  RESULTS
  A total of 379 prostatectomy patients who were transfused and 758 nontransfused controls were followed for 9.4 and 10.2 years (median), respectively. In a multivariable analysis that took into account the matched study design and adjusted for positive surgical margins and adjuvant therapies, the use of allogeneic blood was not associated with systemic tumor progression (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.39-1.99; p = 0.76), prostate cancer-specific death (HR, 1.69; 95% CI, 0.44 to 6.48; p = 0.44), or all-cause death (HR, 1.20; 95% CI, 0.87 to 1.67; p = 0.27).
  
  
  CONCLUSIONS
  When adjusted for clinicopathologic and procedural variables transfusion of allogeneic blood was not associated with systemic tumor progression and survival outcomes.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; Department of Anaesthesia, National University Hospital, National University Health System, Republic of Singapore.
authors.forename: Tze Yeng
authors.initials: TY
authors.lastname: Yeoh
authors.forename: Federica
authors.initials: F
authors.lastname: Scavonetto
authors.forename: Toby N
authors.initials: TN
authors.lastname: Weingarten
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Karnes
authors.forename: Camille M
authors.initials: CM
authors.lastname: van Buskirk
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Hanson
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Schroeder
authors.forename: Juraj
authors.initials: J
authors.lastname: Sprung
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D065227:Transfusion Reaction