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O R Busch

Publications and source records attributed to O R Busch.

25 records · Page 2Linked to original sources
PubMed1993

Prognostic impact of blood transfusions on disease-free survival in colorectal carcinoma.

Blood transfusions have been indicated as having an adverse effect on the prognosis of patients treated surgically for cancer. We carried out a randomized trial to investigate whether a predeposit autologous blood transfusion program improved prognosis in patients with colorectal cancer as compared to the current practice of allogeneic transfusion. This appeared not to be the case. However, the subgroup of untransfused patients had a significantly better disease-free survival compared with transfused patients; 73% and 59%, respectively (p = 0.001). We found that the risk of recurrence was significantly increased for patients transfused with allogeneic, or with autologous, or with both types of blood, compared with those patients who did not require transfusions; relative recurrence rates were 2.3 (p = 0.001), 1.8 (p = 0.044) and 2.5 (p = 0.009), respectively; these three rates did not differ significantly from each other. We conclude that it is not the blood transfusions themselves, but the circumstances that necessitate the transfusions that are the real determinants of prognosis.

Aged↗
PubMed1992

Efficacy of recombinant erythropoietin for stimulating erythropoiesis after blood loss and surgery. An experimental study in rats.

Perioperative administration of recombinant human erythropoietin (rEpo) may reduce the need for allogeneic blood transfusions by diminishing the time lag between blood loss and erythropoiesis and by generating more adequate Epo levels. The efficacy of pre- and postoperative rEpo was studied in rats subjected to blood loss (20% of the blood volume) and surgery (ileal resection). After 200 U rEpo/kg daily for 5 days postoperatively, hemoglobin had increased by 15.7 g/l in these rats but by 36.9 g/l in rEpo-treated controls without surgery (p less than 0.05), indicating an inhibitory effect of surgery on erythropoiesis. A course of 200 U rEpo/kg/day for 5 days, starting 4 or 2 days before operation and blood loss, resulted in significantly higher postoperative hemoglobin levels than in untreated controls. Such difference did not occur if rEpo treatment was begun on the day of operation. Prolonged (10-day) postoperative rEpo treatment was of minor benefit, inducing significant increase in hemoglobin and hematocrit only from day 8 onwards. The study indicates that rEpo is a promising agent to obviate need for perioperative blood transfusions, provided that the treatment is begun before operation.

Animals↗
PubMed1991

The influence of blood loss on tumour growth: effect and mechanism in an experimental model.

Retrospective studies have provided indirect evidence that allogeneic blood transfusion may adversely influence the prognosis of cancer patients. This effect may be prevented by using autologous blood transfusions. However, this involves preoperative donation of blood, the consequences of which are still unknown. The aim of the present study was to investigate the possible effects of blood loss on tumour growth and on NK-cell activity. An artificial lung metastasis model was used in the BN rat from which 20 per cent of the blood volume was taken at different time intervals. The results showed that blood loss, one day prior to tumour challenge, had a profound stimulating effect on tumour growth. After blood loss, the number of lung metastases was doubled as compared to controls. This tumour-promoting effect could be prevented by an immediate plasma transfusion, but not by evoking a normal haemoglobin level after blood loss by pretreatment with recombinant erythropoietin (rEpo). The NK-cell activity of spleen cells was significantly depressed, 24 hours after blood loss. At a 50:1-lymphocyte-to-target cell ratio, the NK-cell activity dropped from 25.3 per cent in controls to 9.3 per cent in experimental animals. Since NK-cells are assumed to play a role in the clearance of tumour cells from the circulation, the enhanced tumour growth observed after blood loss might be caused by this depression.

Animals↗
PubMedDate not supplied

Colorectal cancer recurrence and perioperative blood transfusions: a critical reappraisal.

The last 2 decades the immunomodulatory effect of blood transfusions has been investigated intensively. The effect of blood transfusions on the prognosis of colorectal cancer patients is reviewed in this paper. We made an evaluation of the material from animal and from clinical studies present in the literature. The results from clinical randomized trials dealing with this subject, which have been published recently, are discussed as well.

Animals↗
PubMedDate not supplied

The effect of blood transfusions on survival after surgery for colorectal cancer.

The immunosuppressive effect of allogeneic blood transfusions can be associated with a poor prognosis for cancer patients. Predeposit autologous blood transfusions could be a solution to overcome this putative deleterious effect. We performed a randomised clinical study to compare the effects of autologous with allogeneic blood transfusions in colorectal cancer patients. There was no significant difference in disease-free survival between both randomisation arms. However, the transfused patients had a significantly shorter disease-free interval as compared with the non-transfused patients. This association of transfusions with recurrent disease was only the case for local recurrences, whereas the incidence of distant metastases was unaffected. We conclude that the use of a predeposit autologous blood transfusion programme does not improve the prognosis in colorectal cancer patients. The negative association between blood transfusions and cancer recurrence is only true for local recurrences, which suggests that not the blood transfusions themselves but rather the circumstances necessitating them are the real predictors of prognosis.

Adult↗