180 The effect of packed red blood cell transfusions on the clinical efficacy of immunotherapy

• DOI: 10.1136/jitc-2020-sitc2020.0180
• Publication Date: 2020-11-09T18:54:53Z
• Authors: Christopher D’Avella; Karthik Devarajan; Martin Edelman; Daniel Geynisman
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282; 3. Good health

<h3>Background</h3> Transfusions of packed red blood cells (PRBC) have been postulated to be immunosuppressive, an effect known as transfusion-related immunomodulation (TRIM). TRIM is thought a result the immunosuppressive and pro inflammatory effects residual leukocytes, apoptotic cells, mediators, micro particles free hemoglobin¹ Prior studies shown negative association between perioperative PRBC transfusions overall mortality in multiple malignancies.^2–13 To date there are no addressing impact on survival patients undergoing treatment with checkpoint inhibitor (CPI) immunotherapy. We conducted retrospective study investigate clinical outcomes associated non-small cell lung cancer (NSCLC), urothelial carcinoma (UC) renal (RCC) who received immunotherapy for advanced/metastatic disease. <h3>Methods</h3> From January 2010 - June 2019, at Fox Chase Cancer Center transfusion within 120 days CPI advanced NSCLC, UC RCC were included. Patient demographics including age, sex, ethnicity, race, tobacco use ECOG performance status (PS) abstracted. also assessed previous chemotherapy, radiation targeted therapy utilization among all patients. The primary endpoints progression (PFS) (OS) those not PRBCs. then evaluated PFS OS via cox proportional hazards model that was adjusted type, PS, therapies use. <h3>Results</h3> 304 272 24 8 subjects evaluated. 54 underwent minimum one during pre-specified time period. Both median (8.2 months versus 3.9) (26.1 13.8) shorter transfusion. After multivariable adjustment, associations (HR: 1.53, p=0.03) 1.40, p=0.09) preserved (figure 1–2). A sub-analysis NSCLC (HR:1.58, (HR:1.56, P=0.03) again seen cohort 3–4). <h3>Conclusions</h3> led inferior receiving inhibitors even after adjustments prognostic variables. These results suggest possible attenuation effectiveness transfusions. findings require prospective mechanistic confirmation inherent bias may exist this analysis. <h3>Ethics Approval</h3> This approved institutional review board Center, approval number 19-9006. <h3>Consent</h3> N/A <h3>References</h3> Goubran H, Sheridan D, Radosevic J, Burnouf T, Seghatchian Transfusion-related cancer. <i>Transfusion Apheresis Science</i> 2017;<b>56</b>:336–340. Acheson AG, Brookes MJ, Spahn DR. Effects allogeneic colorectal surgery. <i>Ann Surg</i> 2012; <b>256</b>:235–244. Morgan TM, et al., relationship radical cystectomy bladder <i><i>Urol</i>. <i>Oncol. Semin. Orig. Investig</i></i> 2013;<b>31</b>:871–877. Linder, recurrence following cystectomy. <i>Eur. Urol</i>. 2013;<b>63</b>:839–45. Luan Ye F, Wu L, Zhou Y, Jiang J. Perioperative adversely affects prognosis resection cancer: systematic meta-analysis. <i>BMC Surgery</i> 2014; <b>14</b>:34. Lee Chin J-H, Kim J-I, E-H, Choi I-C. Association long-term esophagus esophagectomy. <i>Dis. Off. Int. Soc. Dis</i>. <i>Esophagus</i> 2017;<b>31</b>:1–8. Sun C, Wang Yao HS, Hu ZQ. Allogeneic gastric patients: <i>Int. 2015;<b>13</b>:102–110. al. worse resected <i>Ann. Thorac. 2014;<b>97</b>:1827–1837. Abu-Ghanem Zilberman DE, Dotan Z, Kaver I, Ramon nephrectomy carcinoma. <i>Urol. Oncol</i> 2018;<b>36</b>:12–20. Pang Q-Y, An R, Liu H-L, surgery: <i>World Surg. 2019;<b>17</b>:1–11. Lopez-Aguiar <i>et al</i>., gallbladder 10-institution from us extrahepatic biliary malignancy consortium. <i>J. Oncol</i>. 2018;<b>117</b>:1638–1647. Reeh M, Allogenic poor outcome esophageal 2017;<b>41</b>:208–215. Moschini al</i>. submitted cystectomy: role anemia status. Urol. Focus</i>. 2016;<b>2</b>:86–91.