Impact of hemoglobin levels on tumor oxygenation: the higher, the better?

摘要: Tumor hypoxia has been linked to tumor progression, the development of treatment resistance, and thus poor prognosis. Since anemia is a major factor causing hypoxia, association between blood hemoglobin concentration (cHb) oxygenation status examined. Published data on relationship pretreatment cHb values (in terms median pO2 values, hypoxic fractions) have summarized. Pretreatment O2 tension measurements were performed in histologically proven experimental tumors, human breast cancers, squamous cell carcinomas head neck, cancers uterine cervix vulva. In order allow for comparison solid tumors normal tissues, also healthy tissue anemic nonanemic patients. was determined at time measurements. Based current information from clinical studies there increasing evidence that associated with detrimental status. Increasing are correlated significantly higher lower fractions. Maximum observed (gender-specific) (approximately 14 g/dl women approximately 15 men). Above this “optimal” Hb range, tends worsen again. patients, compromised due decreased transport capacity blood. At upper edge scale, substantial increase blood’s viscous resistance flow “chaotic” microvessels thought be mainly responsible restriction supply. Review relevant suggests maximum expected range 12 < 13 men. Considering regard oxygenation, concept “the higher, better” therefore no longer valid. This finding potentially far-reaching implications setting (e. g., inappropriate erythropoietin patients).