Background/Objectives: Prior studies suggest that blood transfusion may adversely affect the survival of patients with cancer via transfusion-related immunomodulation. The objective of our study is to investigate the association between transfusion during neoadjuvant chemotherapy and survival in children, adolescent, and young adult (CAYA, 39 years old or younger) patients with osteosarcoma.Methods: This is a multicenter retrospective cohort study of patients between 2007 and 2022. Our primary exposure was receipt of any blood product in the neoadjuvant period (i.e., neoadjuvant transfusion). The primary outcome of interest was 3-year event-free survival (EFS) calculated using the Kaplan–Meier method, while secondary outcomes of interest included 5-year EFS and 3- and 5-year overall survival (OS). Firth multivariable logistic regression models were constructed to evaluate the adjusted association between transfusion status and 3- and 5-year EFS and OS.Results: In total, 73 patients were included in the analytic sample; among them, 34 received neoadjuvant transfusion. There was no significant difference between transfused and non-transfused groups in race, ethnicity, tumor location, stage at diagnosis, histologic response to neoadjuvant chemotherapy, and receipt of ifosfamide or radiation during initial treatment. The transfusion group included more females (p= 0.02) and lower median hemoglobin at diagnosis (p= 0.002) than the non-transfusion group. EFS and OS did not significantly vary by transfusion status or type.Conclusions: We did not observe an adjusted association between neoadjuvant transfusion and survival in CAYA patients with osteosarcoma.
背景/目的：先前研究表明，输血可能通过输血相关免疫调节对癌症患者的生存产生不利影响。本研究旨在探讨儿童、青少年及年轻成人（CAYA，年龄≤39岁）骨肉瘤患者在新辅助化疗期间输血与生存结局之间的关联。 方法：本研究为一项多中心回顾性队列研究，纳入2007年至2022年间的患者。主要暴露因素为新辅助治疗期间接受任何血液制品输注（即新辅助输血）。主要结局指标为采用Kaplan-Meier法计算的3年无事件生存率（EFS），次要结局指标包括5年EFS以及3年和5年总生存率（OS）。通过构建Firth多变量逻辑回归模型评估输血状态与3年及5年EFS、OS之间的校正后关联。 结果：分析样本共纳入73例患者，其中34例接受新辅助输血。输血组与非输血组在种族、民族、肿瘤部位、诊断分期、对新辅助化疗的组织学反应以及初始治疗期间是否接受异环磷酰胺或放疗方面均无显著差异。与非输血组相比，输血组女性比例更高（p=0.02），诊断时中位血红蛋白水平更低（p=0.002）。EFS和OS在不同输血状态或输血类型间未见显著差异。 结论：在CAYA骨肉瘤患者中，我们未观察到新辅助输血与生存结局之间存在校正后的关联。
肿瘤(癌症)患者之家