A study of placental umbilical cord whole blood transfusion in 72 patients with anemia and emaciation in the background of cancer.

In the under-resourced world, transfusion to advanced oncological patients involves two major problems, i.e., (a) transfusion transmitted disease, and (b) infrastructural deficiency. Many hospitals cannot cope with the specialized requirements of immunocompromised cancer victims, for instance, leucoreduction, selective apheresis, irradiation of the blood, viral inactivation of the blood by solvent and/or detergent treatment or photochemical inactivation using psoralen or long wavelength ultraviolet light and cytomegalovirus safe blood. The exorbitant cost of red blood cell (RBC) substitutes like hemoglobin-based oxygen carriers or perflurocarbon emulsions, liposome encapsulated hemoglobin, is simply unacceptable for an average oncological patient in the developing world. Moreover, it should be underscored that none of the total blood functions are replaced by any available so-called blood substitute, the primary function of which is oxygen delivery and volume expansion only. A more accurate term should be red cell substitute. Cord blood, because of its rich mix of fetal and adult hemoglobin, platelet and white blood cell (WBC) count, and plasma filled with cytokine and growth factors--as well as its hypoantigenic nature and altered metabolic profile--has all the potential of a real and safe alternative to adult blood during emergencies or any etiology of blood loss. In the present series, the collection of cord blood varied from 54 ml-128 ml, mean 82 ml +/- 7.6 ml SD; mean packed cell volume 48 +/- 4.1% SD; mean percent hemoglobin concentration 16.4 g/dl +/- 1.6 g/dl SD. Not a single case of immunological or non immunological reaction has been encountered so far after transfusion of cord blood to cancer patients with percent of hemoglobin 8 g/dl or less. It appears that the medical fraternity can safely use this precious gift of nature-- which is free from infection, hypoantigenic with altered metabolic profile, filled with growth factors and cytokine-filled plasma, and has the potential of a higher oxygen carrying capacity than adult blood--as an emergency source of blood for the management of advanced cancer cases with anemia.