INFLUENCE OF AUTOLOGOUS BLOOD-TRANSFUSION ON NATURAL-KILLER AND LYMPHOKINE-ACTIVATED KILLER-CELL ACTIVITIES IN CANCER-SURGERY

Background and objectives: Immunosuppression associated with blood tra nsfusion may influence postoperative infection rates. It may also affe ct the prognosis of patients treated surgically for colorectal cancer. To control this effect, study protocols have applied autologous blood donation programs, which are thought to be immunologically neutral. H owever, evidence has emerged that blood donation itself might have sup pressive effects on natural killer (NK) cell activities. At present, t here are no data available on the effects of autologous blood transfus ion on NK or lymphokine-activated killer (LAK) cells. This might be of interest as LAK cells may be active in tumor control. Materials and m ethods: 26 patients who underwent surgical resection for colorectal ca ncer, were assigned at random into two groups: (1) autologous blood do nation and transfusion, or (2) allogeneic blood transfusion. NK and LA K activities were determined before blood donation, at surgery, and on the 3rd and 8th postoperative day. Results: Blood donation induced a small decrease in NK and LAK activities. The postoperative courses of the two groups differed. In the allogeneic group, NK activity (-50%, p = 0.018) and LAK activity decreased (-60.7%, p = 0.043), whereas in t he autologous group the decline in LAK was less pronounced (-33.7%, p = 0.091), and their NK activity even increased (+17.4%, p = 0.315). NK activity was modulated differently in the two study groups (0.0036). Differences in LAK activities were found between the 3rd and 8th day p ostoperatively (p = 0.354). Conclusions: In patients receiving autolog ous blood transfusion, postoperative suppressed NK and LAK activities were modulated. This implies that autologous blood transfusion is not immunologically neutral, but has an intrinsic immunomodulatory potenti al.