Risk of Increased Post-Transfusion IL-8 Levels in Adult Patients with Malignancy Receiving Non-Leukodepleted Packed Red Cell Transfusions

Background: Cancer is one of the primary causes of death, and almost 40% of cancer patients experience anemia. Transfusion serves as one of the therapies given to anemic patients. Malignancy patients with decreased immune systems which are given blood component transfusion may cause transfusion reactions (Transfusion-related immunomodulation or TRIM), the mechanism of which is suspected to correlate to inflammatory cytokines, including IL-8. Blood products with a leukocyte count of 5 × 106 per unit are called leukodepleted blood products. This study aimed to observe the incidence of increased IL-8 level in malignancy patients given leukodepleted (LD) and nonleukodepleted (NLD) Packed Red Cells (PRC) transfusions. The increased IL-8 level leads a possibility of recurrence and risk of infection.Methods: This study was a quasi-experimental clinical trial conducted on 39 adult malignancy patients treated at Dr.Sardjito Hospital which were given leukodepleted and nonleukodepleted PRC transfusions, and the IL-8 levels were measured one hour before and after the transfusions.Results: IL-8 levels in the NLD and LD groups increased significantly (p 0.05), i.e. 13.25 (8.3-25.2) pg/mL and 9.1 (8.4-10.8) pg/mL before the transfusions, and 25.4 (9.9-72.6) pg/mL and 9.8 (9.1-11.6) pg/mL after the transfusions, respectively. It showed that the increase of IL-8 levels correlated to the given PRC transfusions. There was a significant difference in the median IL-8 levels of the LD and NLD groups before and after the transfusions. The relative risk of increased IL-8 levels in nonleukodepleted PRC transfusions was 4.0 (95% CI: 1.079-14.833).Conclusion: Nonleukodepleted PRC transfusions have a four times higher risk of increasing IL-8 levels than leukodepleted PRC transfusions.