Posted by: Chris Maloney | June 26, 2013

Is There Something In The Blood? Lymphoma And Blood Transplants.

English: WWII Syringe for direct interhuman bl...

English: WWII Syringe for direct interhuman blood transfusion. (C)opyleft 2004, Thomas Hirsch (Photo credit: Wikipedia)

If there is one thing we all know, it’s that you can’t “catch cancer.”  The idea that one person can transmit cancer to another is completely contrary to the whole model of cancer research.  We develop cancer within ourselves, and do not transfer it.

One of the more disturbing aspects of Lymphomas is that they seem to correlate with a variety of things that we typically place in the infectious disease category.  There is a connection between Lymphomas and a variety of chronic viral diseases.  And now there is evidence that undergoing a blood transfusion can increase your risk of developing Lymphoma.

Now, before we all go out and start refusing blood transfusions, the risk is not great.  It was barely noticeable for the acute diseases and only reached significance for the chronic Lymphomas.  I assume that anyone getting a blood transfusion needed it to stay alive, so the risk is worth it.

But the existence of a link points to the possibility of something in the blood (besides viruses, which we all hope are screened for) that increases the risk of Lymphoma.  We know that different blood types cause terrible problems when mixed, but what if we aren’t subtyping sufficiently and there is a lower, slower response to incompatible blood?

Here’s the review:

Blood. 2010 Oct 21;116(16):2897-907. doi: 10.1182/blood-2010-03-276683. Epub  2010 Jul 12.

Association between red blood cell transfusions and development of non-Hodgkin lymphoma: a meta-analysis of observational studies.

Source

The Warren Alpert Medical School of Brown University, Division of Hematology and Oncology, The Miriam Hospital, Providence, RI 02906, USA. jcastillo@lifespan.org

Abstract

The incidence of non-Hodgkin lymphoma (NHL) has increased steadily for the past few decades. Previous studies have suggested an association between blood transfusions and NHL. The main objective of this study was to evaluate this relationship with a meta-analysis of observational studies. A literature search was undertaken, looking for case-control and cohort studies evaluating the risk of developing NHL in persons who received allogeneic blood transfusions; 14 studies were included. Outcome was calculated and reported as relative risk (RR). Heterogeneity was assessed with Cochrane Q and I(2) statistics. Dissemination bias was evaluated by funnel plot visualization and trim-and-fill analysis. Quality assessment was performed with the Newcastle-Ottawa scale. Our analysis showed a RR of developing NHL of 1.05 (95% CI, 0.89-1.25; P = .42) and 1.34 (95% CI, 1.15-1.55; P < .01) in case-control and cohort studies, respectively. When pooling all studies, RR was 1.2 (95% CI, 1.07-1.35; P < .01). In subset analysis, RR of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was 1.66 (95% CI, 1.08-2.56; P = .02). The RR of NHL was elevated in both men and women and in persons receiving transfusions either before or after 1992. Blood transfusions appear to increase the risk of developing NHL; however, the risk of CLL/SLL appears higher than for other NHL subtypes.

Comment in

PMID:
20625008
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