Blood Transfusion Before Radiation for Malignancies

To the Editor.—  One of your questioners, Dr Mullins¹ of Corpus Christi, Tex, asked about the rationality of giving blood transfusions in expectation of enhancing the effectiveness of radiation therapy for malignancy in anemic patients. Your consultant, Dr Glatstein, felt that the practice was orthodox and rational because radiation therapy is more effective in well-oxygenated cells and because hemoglobin is likely to increase the oxygenation of tumor cells.I feel that Dr Mullins asked an important question, and would like to differ somewhat from the answers given in your column. First, I do not dispute the evidence that links susceptibility to ionizing radiation with increased tumor/ tissue PO₂. However, I do contest the assumption that increased hemoglobin concentrations achieve increased tissue/tumor PO₂.The role of hemoglobin is, in fact, to support PO₂ in tissues that rapidly consume oxygen, the best example of which is working muscle.