The Relationship between IL-1beta, TNFalpha, IL-6 and Factors Associated with Febrile Reactions to Transfused Blood

Kyung, Hae Shin; Ryu, Kyung Ha; Kim, Kyung Hyo; Hong, Young Mi; Kim, Kyung Hi; Lee, Keun

Abstract

PURPOSE: Aggressive chemotherapy and bone marrow transplantation have a large demand for platelet concentrate and packed RBC transfusion. Febrile nonhemolytic transfusion reactions are an immunologically mediated reaction involving plasma in the recipient and the white blood cells in the donor. This study was performed to understand the role of cytokines and factors associated with febrile nonhemolytic transfusion reaction to transfused blood.
METHODS
Samples were obtained from 42 transfused blood(36 packed RBC, 6 platelet concentrates). Initial WBC count, pH, LDH, irradiation, use of filter and storage time were checked. The serum levels of Interleukin-1beta(IL-1beta), Tumor necrosis factor alpha(TNFalpha) and Interleukin-6(IL-6) were measured by ELISA method using commercial kit for each cytokines. Transfusion reactions, including fever, were recorded in all cases.
RESULTS
With the storage time of blood products longer in duration, the serum levels of IL-1beta, TNFalpha and IL-6 were significantly higher(P<0.05). The serum levels of IL-1beta, TNFalpha and IL-6 increased significantly as these blood products were more contaminated with WBC>3000/mm3(P< 0.05). There was no relationship between cytokines and LDH, pH respectively. Febrile reaction was noted in 2.3%(1/42).
CONCLUSION
Transfusion reactions are not always the result of an antigen-antibody reaction, but could be caused by the administration of large amounts of cytokines in the plasma. The longer storage times of blood products was associated with frequency of febrile transfusion reactions. We recommend fresh blood transfusion and reduction of WBC before storage because it abrogates cytokine accumulation and dramatically lowers the rate of febrile transfusion reaction.