Director of the URMC Clinical Laboratories since 2004. Director of the Transfusion Medicine Unit, Blood Bank, and Stem Cell Storage Facility since 1980. An expert in the field of blood transfusion immunology, Dr. Blumberg has worked to enhance the quality, safety, and efficiency of transfusion services at Strong Memorial Hospital and across the broader medical community. His long-standing clinical and research foci are immune cytopenias, supportive care for patients with hematologic malignancies, and the immunologic sequela of transfusion therapy.

Qualifications

M.D., Yale University School of Medicine 1975
Clinical Fellow, Laboratory Medicine, Yale-New Haven Hospital 1975-76
Residency in Laboratory Medicine, Yale-New Haven Hospital 1976-78
Board Certification, American Board of Pathology (Clinical Pathology) 1978

Professional Activities

Member, Editorial Board, TRANSFUSION, 1990-present
Member, Editorial Board, BLOOD, 2008-2013
Chair, Study Monitoring Board, NHLBI Retrovirus Epidemiology Donor Study II (REDS II) 2005-2009

Research Overview

Blood transfusions are known to be broadly immunomodulatory and are associated with substantially poorer clinical outcomes in surgical and cancer patients, and better outcomes in solid organ allograft recipients. Our laboratory and clinical group has been interested for the last twenty years in the disparate effects of autologous and allogeneic transfusions on immune function, as well as the potential benefits of removing allogeneic white cells and stored supernatant plasma from blood components before transfusions.

Our studies demonstrated that patients receiving leukocyte-reduced allogeneic blood transfusions for leukemia, and those receiving leukocyte-reduced allogeneic or autologous transfusions during surgical procedures, experienced reduced morbidity and mortality compared with patients receiving unmodified allogeneic transfusions. We were the first to document that one likely mechanism for these benefits is that allogeneic transfusions promote type 2 (Th2) cellular immunity and down regulate type 1 (Th1) immunity. Leukoreduction or use of autologous transfusions reduces these immunologic effects. We also have pioneered clinical outcomes and cost-effectiveness analyses in the study of transfusion immunomodulation.

Transfusions, however, can also promote inflammatory processes. Platelet transfusions are associated with a dose dependent increase in multi-organ failure syndrome in surgical patients. Work done in collaboration with Dr. Rick Phipps's laboratory has shown that stored platelet transfusion supernatant promotes cellular secretion of PGE2 , IL6 and IL8 in vitro through a soluble CD40L dependent mechanism. Current investigations include clinical and laboratory studies of the effects of stored platelet supernatant CD40L on clinical outcomes and in vitro immunologic function. We are also exploring the possible use of autologous stored platelet supernatant for immunotherapeutic use.

Publications

Coppage M, Baker, M, Fialkow L, Meehan D, Gettings K, Chen L, Massey HT, Blumberg N.  Lack of significant de novo HLA allosensitization in ventricular assist device recipients transfused with leukoreduced, ABO identical blood  products. Human Immunology. 2009 Jun;70(6)413-6.

Springer DL, Miller JH, Spinelli SL, Pasa-Tolic L, Purvine SO, Daly DS, Zangar RC,   Jin S, Blumberg N, Francis CW, Taubman MB, Casey AE, Wittlin SD, Phipps RP. Platelet proteome changes associated with diabetes and during platelet storage for transfusion. J. Proteome Research. 2009 May;8(5):2261-72.

Kanda J, Ichinohe T, Matsuo K, Benjamin RJ, Klumpp TR, Rozman P, Blumberg N, Mehta J, Sohn S-K, Uchiyama T. Impact of ABO mismatching on the outcomes of allogeneic related and unrelated blood and marrow stem cell transplantations for hematologicmalignancies:  Individual patient data-based meta-analysis of cohort studies.  Transfusion. 2009 Apr; 49(4):624-635.

O’Brien J, Baglole CJ, Garcia-Bates TM, Blumberg N, Francis CW, Phipps RP. 15d-PGJ2-induced heme oxygenase-1 in megakaryocytes regulates thrombopoiesis. Journal of Thrombosis and Haemostasis.  2009 Jan;7(1):182-189.

Blumberg N, Heal JM, Liesveld, J, Phillips, G, Rowe JM. Platelet transfusion and survival in adults with acute leukemia.  Leukemia. 2008 Mar;22(3):631-635.             

Chollette JM, Blumberg N, Phipps RP, McDermott MP, Gettings KF, Lerner NB. Developmental changes in soluble CD40 ligand. J Pediatric. 2008 Jan;152(1):50-4.

Khorana A, Francis CW, Blumberg N, Culakova E, Refaai M, Lyman G.  Blood transfusions, thrombosis and mortality in hospitalized cancer patients. Archives  of Internal Medicine. 2008 Nov;168(21):2377-81.

Hillyer CD, Blumberg N, Glynn SA, Ness PM for the members of the NHLBI Working Group. Transfusion recipient epidemiology and outcomes research: possibilities for the future. Transfusion. 2008 Aug;48(8):1530-1537.

O’Brien J, Spinelli S, Tober J, Blumberg N, Francis C, Taubman M, Palis J, Seweryniak K,Gertz J, Phipps R. 15-deoxy-delta12,14-PGJ2 enhances platelet production from megakaryocytes.  Blood. 2008 Nov;112(10):4051-4060.

Blumberg N, Zhao H, Wang H, Messing S, Heal JM, Lyman GH. The intention-to-treat principle in clinical trials and meta-analyses of leukoreduced blood transfusions in surgical patients. Transfusion. 2007 Apr;47(4):573-81.

O'Brien JJ, Ray DM, Spinelli SL, Blumberg N, Taubman MB, Francis CW, Wittlin SD, Phipps RP. The platelet as a therapeutic target for treating vascular diseases and the role of eicosanoid and synthetic PPARgamma ligands. Prostaglandins Other Lipid Mediat. 2007 Jan;82(1-4):68-76. Epub 2006 Jul 10.

Rogers MA, Blumberg N, Saint SK, Kim C, Nallamothu BK, Langa KM. Allogeneic blood transfusions explain increased mortality in women after coronary artery bypass graft surgery. Am Heart J. 2006 Dec;152(6):1028-34.

Blumberg N, Francis CW, Heal JM eds. Clinical use of plasma and plasma fractions. In Best Practice and Research in Clinical Haematology, Elsevier, UK, 2006.

Blumberg N, Heal JM. Transfusion immunomodulation. In Hillyer et all eds. Blood Banking and Transfusion Medicine: Basic Principles and Practice. 2nd edition, 2006.

Blumberg N, Gettings KF, Turner C, Heal JM, Phipps RP. An association of soluble CD40 ligand (CD154) with adverse reactions to platelet transfusions. Transfusion. 2006 Oct;46(10):1813-21.

Blumberg N. International Forum: Haemovigilance. Vox Sanguinis 2006 90: 237-239.

Blumberg N, Heal JM. Immunomodulation by transfusion. In Spiess B et al. Perioperative Transfusion Medicine. Lippincott, Williams & Wilkins, 2nd edition, 2005.

Ray DM, Spinelli SL, O'Brien JJ, Blumberg N, Phipps RP Platelets as a novel target for PPARgamma ligands : implications for inflammation, diabetes, and cardiovascular disease. BioDrugs. 2006;20(4):231-41. Review.

Khan SY, Kelher MR, Heal JM, Blumberg N, Boshkov LK, Phipps R, Gettings KF, McLaughlin NJ, Silliman CC. Soluble CD40 ligand accumulates in stored blood components, primes neutrophils through CD40, and is a potential cofactor in the development of transfusion-related acute lung injury. Blood. 2006 Oct 1;108(7):2455-62. Epub 2006 Jun 13.

Blumberg N, Fine L, Gettings KF, Heal JM. Decreased sepsis related to indwelling venous access devices coincident with implementation of universal leukoreduction of blood transfusions. Transfusion. 2005 Oct;45(10):1632-9.

Blumberg N. Deleterious clinical effects of transfusion immunomodulation: proven beyond a reasonable doubt. Transfusion. 2005 Aug;45(2 Suppl):33S-39S; discussion 39S-40S. Review.

Heal JM, Liesveld J, Phillips G, Blumberg N. What would Karl Landsteiner do? The ABO blood group and stem cell transplantation. Bone Marrow Transplant. 2005 Nov;36(9):747-55. Review.

Blumberg N, Heal JM, Rowe JM. A randomized trial of washed red blood cell and platelet transfusions in adult acute leukemia [ISRCTN76536440]. BMC Blood Disord. 2004 Dec 10;4(1):6.

Horan JT, Liesveld JL, Fenton P, Blumberg N, Walters MC. Hematopoietic stem cell transplantation for multiply transfused patients with sickle cell disease and thalassemia after low-dose total body irradiation, fludarabine, and rabbit anti-thymocyte globulin. Bone Marrow Transplant. 2005 Jan;35(2):171-7.

Heal JM, Blumberg N. Optimizing platelet transfusion therapy. Blood Rev. 2004 Sep;18(3):149-65.

Akbiyik F, Ray DM, Gettings KF, Blumberg N, Francis CW, Phipps RP. Human bone marrow megakaryocytes and platelets express PPAR{gamma} and PPAR{gamma} agonists blunt platelet release of CD40 ligand and thromboxanes. Blood. 2004 Sep 1;104(5):1361-1368. Epub 2004 May 06.

Blumberg N, Heal JM. Erythropoietin to treat anaemia in patients with head and neck cancer. Lancet. 2004 Jan 3;363(9402):80-1; author reply 81-2.

Koumas L, Smith TJ, Feldon S, Blumberg N, Phipps RP. Thy-1 expression in human fibroblast subsets defines myofibroblastic or lipofibroblastic phenotypes. Am J Pathol. 163:1291-300, 2003.

Blumberg N, Heal JM, Gettings KF. WBC reduction of RBC transfusions is associated with a decreased incidence of RBC alloimmunization.Transfusion 43:945-52, 2003.

Goldman J, Liesveld J, Nichols D, Heal J, Blumberg N. ABO incompatibility between donor and recipient and clinical outcomes in allogeneic stem cell transplantation. Leuk Res 27:489-91, 2003.

Blumberg N, Phipps RP, Kaufman J, Heal JM. The causes and treatment of reactions to platelet transfusions. Transfusion. 43:291-292, 2003.

Blumberg N, Heal JM, Cowles JW, Hicks GL Jr, Risher WH, Samuel PK, Kirkley SA. Leukocyte-reduced transfusions in cardiac surgery results of an implementation trial. Am J Clin Pathol. 118:376-81, 2002.

Vanderlinde ES, Heal JM, Blumberg N. Autologous transfusion. BMJ. 324:772-5, 2002.

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