Peripartum Blood Transfusions are Associated with Increased Risk of Cancer: A National Retrospective Cohort Study
Authors Cho GJ, Oh MS, Oh MJ, Park KV, Han SW, Chae YK
Received 1 January 2020
Accepted for publication 24 April 2020
Published 19 June 2020 Volume 2020:12 Pages 659—666
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Eyal Cohen
Geum Joon Cho,1 Michael S Oh,2 Min-Jeong Oh,1 Keon Vin Park,3 Sung Won Han,3 Young Kwang Chae2,4
1Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Republic of Korea; 2Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; 3School of Industrial Management Engineering, Korea University, Seoul, Republic of Korea; 4Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
Correspondence: Young Kwang Chae
Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue, Suite 1006, Chicago, IL 60611, USA
Tel +1 312-926-4248
Background: The effect of blood transfusions on the risk of developing primary cancer remains unclear, especially when administered in the peripartum period.
Materials and Methods: We conducted a retrospective cohort study of 270,529 pregnant women who delivered between January 1, 2007 and December 31, 2009, with data obtained from three national databases in South Korea. From this cohort, we identified 4569 patients who received peripartum blood transfusions. We calculated hazard ratios (HRs) for new diagnoses of cancer and adjusted them for relevant clinical factors using a Cox proportional hazards model.
Results: During follow-up, patients who received peripartum transfusions had an increased risk of developing cancer, with an adjusted HR of 1.16 (95% confidence interval [CI], 1.01– 1.34). In a subgroup analysis, this risk was significant only among patients who received 3 or more units of blood, with an adjusted HR of 1.40 (95% CI, 1.10– 1.79). Increased risk after transfusions were seen with brain, lung, ovarian, and gallbladder cancers. The difference in cancer risk between the transfusion and no-transfusion groups remained significant during both the first (1.29% vs 1.07%, p < 0.01) and second year (0.74% vs 0.56%, p < 0.01) after delivery.
Conclusion: Receipt of 3 or more blood transfusions in the peripartum period was associated with a significantly increased risk of developing cancer. Prospective studies should be pursued to further understand the link between blood transfusions and long-term oncologic risks.
Keywords: blood transfusion, pregnancy, cancer, immunomodulation
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