Red blood cell (RBC) transfusions may have a negative impact on the prognosis of patients with cancer, where transfusion-related immunomodulation (TRIM) may be a significant contributing factor. A number of components have been indicated to be associated with TRIM. Among these, the impact of extracellular vesicles (EVs) has been garnering increasing attention from researchers. EVs are defined as nano-scale, cell-derived vesicles that carry a variety of bioactive molecules, including proteins, nucleic acids and lipids, to mediate cell-to-cell communication and exert immunoregulatory functions. RBCs in storage constitutively secrete EVs, which serve an important role in TRIM in patients with cancer receiving a blood transfusion. Therefore, the present review aimed to first summarize the available information on the biogenesis and characterization of EVs. Subsequently, the possible mechanisms of TRIM in patients with cancer and the impact of EVs on TRIM were discussed, aiming to provide an outlook for future studies, specifically for formulating recommendations for managing patients with cancer receiving RBC transfusions.
Contents1. Introduction 2. Impact of RBC transfusions on the prognosis of patients with cancer 3. TRIM in patients with cancer receiving RBC transfusions 4. Biogenesis and characterization of stored RBC-derived EVs 5. Mechanism of stored RBC-derived EVs in TRIM in patients with cancer receiving transfusions 6. Outlook