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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2013

01-06-2013 | Pancreatic Tumors

Hemoglobin-Based Oxygen Carrier Mitigates Transfusion-Mediated Pancreas Cancer Progression

Authors: Karen K. Lo, MD, Erik A. Bey, PhD, Biswantha Patra, PhD, Douglas D. Benson, MD, David A. Boothman, PhD, Christopher C. Silliman, PhD, Carlton C. Barnett Jr., MD

Published in: Annals of Surgical Oncology | Issue 6/2013

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Abstract

Background

Perioperative blood transfusion in pancreatic cancer patients is linked to decreased survival; however, a causal mechanism has not been determined. Previously we have shown that the plasma fraction of stored packed red blood cells (pRBCs) promotes pancreas cancer progression and associated morbidity. We hypothesize these untoward effects will be mitigated by use of a hemoglobin-based oxygen carrier (HBOC).

Methods

Cytokines and growth factors were measured in the plasma fraction from stored pRBCs and in an HBOC via cytokine array followed by formal enzyme-linked immunosorbent assay (ELISA). In an immunocompetent murine model, pancreas cancer progression was determined in vivo by bioluminescence, tumor weight, and number of metastases.

Results

Elevated levels of epidermal growth factor (EGF), platelet-derived growth factor BB (PDGF-BB), and regulated upon activation, normal T cell expressed and secreted (RANTES) were present in the plasma fraction of stored pRBCs, but were not found in the HBOC. Intravenous delivery of plasma fraction to mice with pancreatic cancer resulted in increased bioluminescence activity compared with mice that received HBOC. Metastatic events and pancreatic primary tumor weights were significantly higher in animals receiving plasma fraction from stored pRBCs compared with animals receiving HBOC.

Conclusions

Intravenous receipt of the acellular plasma fraction of stored pRBCs promotes pancreatic cancer progression in an immunocompetent mouse model. These untoward events are mitigated by use of an HBOC.
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Metadata
Title
Hemoglobin-Based Oxygen Carrier Mitigates Transfusion-Mediated Pancreas Cancer Progression
Authors
Karen K. Lo, MD
Erik A. Bey, PhD
Biswantha Patra, PhD
Douglas D. Benson, MD
David A. Boothman, PhD
Christopher C. Silliman, PhD
Carlton C. Barnett Jr., MD
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2842-0

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