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Red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors

Red blood cell (RBC) transfusions have been shown to exert immunosuppressive effects in different diseases. In consequence, RBC transfusions might also negatively influence the response to immunotherapeutic treatment approaches. To address how RBC transfusions impact response rates of antitumor immu...

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Autores principales: Mispelbaum, Rebekka, Hattenhauer, Sandra Tessa, Brossart, Peter, Heine, Annkristin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492841/
https://www.ncbi.nlm.nih.gov/pubmed/36159812
http://dx.doi.org/10.3389/fimmu.2022.976011
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author Mispelbaum, Rebekka
Hattenhauer, Sandra Tessa
Brossart, Peter
Heine, Annkristin
author_facet Mispelbaum, Rebekka
Hattenhauer, Sandra Tessa
Brossart, Peter
Heine, Annkristin
author_sort Mispelbaum, Rebekka
collection PubMed
description Red blood cell (RBC) transfusions have been shown to exert immunosuppressive effects in different diseases. In consequence, RBC transfusions might also negatively influence the response to immunotherapeutic treatment approaches. To address how RBC transfusions impact response rates of antitumor immunotherapy (IT), we conducted a retrolective clinical study of patients with different solid tumors treated with IT (atezolizumab, pembrolizumab, nivolumab and/or ipilimumab). We assessed the number of RBC concentrates received within 30 days before and 60 days after the start of IT. Primary objective was the initial therapy response at first staging, secondary objectives the number of immune related adverse events and infections. 15 of 55 included patients (27.3%) received RBC concentrates. The response rates were 77.5% in the non-transfused (n=40) versus 46.7% in the transfused patient group (n=15) and reached statistical significance (p=0.047). The correlation between therapy response and transfusion was statistically significant (p=0.026) after adjustment for the only identified confounder “line of therapy”. In contrast, transfusion in the interval 30 days before IT showed no significant difference for treatment response (p=0.705). Moreover, no correlation was detected between RBC transfusion and irAE rate (p=0.149) or infection rate (p=0.135). In conclusion, we show for the first time that the administration of RBC transfusions during, but not before initiation of IT treatment, negatively influences the response rates to IT. Our findings suggest a restrictive transfusion management in patients undergoing IT to receive optimal response rates.
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spelling pubmed-94928412022-09-23 Red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors Mispelbaum, Rebekka Hattenhauer, Sandra Tessa Brossart, Peter Heine, Annkristin Front Immunol Immunology Red blood cell (RBC) transfusions have been shown to exert immunosuppressive effects in different diseases. In consequence, RBC transfusions might also negatively influence the response to immunotherapeutic treatment approaches. To address how RBC transfusions impact response rates of antitumor immunotherapy (IT), we conducted a retrolective clinical study of patients with different solid tumors treated with IT (atezolizumab, pembrolizumab, nivolumab and/or ipilimumab). We assessed the number of RBC concentrates received within 30 days before and 60 days after the start of IT. Primary objective was the initial therapy response at first staging, secondary objectives the number of immune related adverse events and infections. 15 of 55 included patients (27.3%) received RBC concentrates. The response rates were 77.5% in the non-transfused (n=40) versus 46.7% in the transfused patient group (n=15) and reached statistical significance (p=0.047). The correlation between therapy response and transfusion was statistically significant (p=0.026) after adjustment for the only identified confounder “line of therapy”. In contrast, transfusion in the interval 30 days before IT showed no significant difference for treatment response (p=0.705). Moreover, no correlation was detected between RBC transfusion and irAE rate (p=0.149) or infection rate (p=0.135). In conclusion, we show for the first time that the administration of RBC transfusions during, but not before initiation of IT treatment, negatively influences the response rates to IT. Our findings suggest a restrictive transfusion management in patients undergoing IT to receive optimal response rates. Frontiers Media S.A. 2022-09-08 /pmc/articles/PMC9492841/ /pubmed/36159812 http://dx.doi.org/10.3389/fimmu.2022.976011 Text en Copyright © 2022 Mispelbaum, Hattenhauer, Brossart and Heine https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Mispelbaum, Rebekka
Hattenhauer, Sandra Tessa
Brossart, Peter
Heine, Annkristin
Red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors
title Red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors
title_full Red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors
title_fullStr Red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors
title_full_unstemmed Red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors
title_short Red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors
title_sort red blood cell transfusions impact response rates to immunotherapy in patients with solid malignant tumors
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492841/
https://www.ncbi.nlm.nih.gov/pubmed/36159812
http://dx.doi.org/10.3389/fimmu.2022.976011
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