Increased Oxidative Stress in Acute Myeloid Leukemia Patients after Red Blood Cell Transfusion, but Not Platelet Transfusion, Results Mainly from the Oxidative/Nitrative Protein Damage: An Exploratory Study

Abstract

Chronic oxidative stress (OS) can be an important factor of acute myeloid leukemia (AML) progression; however, there are no data on the extent/consequence of OS after transfusion of packed red blood cells (pRBCs) and platelet concentrates (PCs), which are commonly used in the treatment of leukemia-associated anemia and thrombocytopenia. We aimed to investigate the effects of pRBC/PC transfusion on the OS markers, i.e., thiol and carbonyl (CO) groups, 3-nitrotyrosine (3-NT), thiobarbituric acid reactive substances (TBARS), advanced glycation end products (AGE), total antioxidant capacity (TAC), SOD, GST, and LDH, in the blood plasma of AML patients, before and 24 h post-transfusion. In this exploratory study, 52 patients were examined, of which 27 were transfused with pRBCs and 25 with PCs. Age-matched healthy subjects were also enrolled as controls. Our results showed the oxidation of thiols, increased 3-NT, AGE levels, and decreased TAC in AML groups versus controls. After pRBC transfusion, CO groups, AGE, and 3-NT significantly increased (by approximately 30, 23, and 35%; p < 0.05, p < 0.05, and p < 0.01, respectively) while thiols reduced (by 18%; p < 0.05). The PC transfusion resulted in the raise of TBARS and AGE (by 45%; p < 0.01 and 31%; p < 0.001), respectively). Other variables showed no significant post-transfusion changes. In conclusion, transfusion of both pRBCs and PCs was associated with an increased OS; however, transfusing the former may have more severe consequences, since it is associated with the irreversible oxidative/nitrative modifications of plasma proteins.

Platelet CD40L Expression Response to Mixing of pRBCs and Washed Platelets but no Causality Association between Platelet ROS Generation and CD40L Expression: An In Vitro Study

“…Third, Khoy et al reported that ROS production upon neutrophil activation plays a role in transfusion-related acute lung injury [ 11 ]. Fourth, Czubak et al reported that oxidative stress increased after RBC transfusion, but not after platelet transfusion [ 12 ]. Above all, this transfusion-related increase in ROS is only observed in macrophages [ 13 ], neutrophils [ 10 , 11 ], and RBCs [ 12 ], but not in platelets, which is consistent with the results of our studies.…”

“…Fourth, Czubak et al reported that oxidative stress increased after RBC transfusion, but not after platelet transfusion [ 12 ]. Above all, this transfusion-related increase in ROS is only observed in macrophages [ 13 ], neutrophils [ 10 , 11 ], and RBCs [ 12 ], but not in platelets, which is consistent with the results of our studies. According to our results, which show that mixing pRBCs and washed platelets does not increase platelet ROS levels, one can imagine that the administration of antioxidants does not suppress the platelet ROS level that is not increasing, as noted in our results ( Figure 3 ).…”

“…ROS are short-lived, highly reactive molecules—regarded as toxic products of cellular metabolism—and can function as signaling molecules that regulate many physiological processes [ 8 , 9 ]. Additionally, ROS are closely related to transfusion reactions through neutrophils [ 10 , 11 ], macrophages, and other circulatory cells or plasma components [ 12 , 13 , 14 , 15 , 16 ]. The low levels of intraplatelet ROS are associated with low levels of platelet pro-inflammatory molecules in stored platelets [ 3 ].…”

Evaluation of antioxidant activity of NG-R1 saponin against bacterial cells in induced oxidative stress – a preliminary study

“…Lipid peroxidation. The level of lipid peroxidation in lysates was measured on the basis of the content of peroxidation products reacting with thiobarbituric acid (0.37% TBA) in 0.25 M HCl [26,27]. The lysates were mixed with trichloroacetic acid (20% TCA) in 0.25 M HCl and TBA, and boiled for 15 min.…”

Superoxide Dismutase and Vitamin E Levels in Serum as Indicators in Patients with Acute and Chronic Leukemia

“…It may help protect against the development of cancer by boosting immune function [22], [23]. Several studies have found a reduction in vitamin E levels in leukemia patients [23,24]. Tsamesidis et al revealed that increased oxidative stress in the serum of leukemia patients is associated with a decrease in vitamin E concentration, total antioxidant capacity (TAC), and an increase in ROS levels [25].…”