摘要:

AbstractCirculating stem cells exist in sufficient numbers in mouse, dog, and man to allow collection and transplantation after ablative treatment. Preclinical studies in the mouse have shown a low concentration, with a transplantation potential ratio of bone marrow to blood of 1:100. The ratio of circulating stem cells to bone marrow stem cells is more favorable in the dog (1:10‐20). Recent pilot studies carried out in different centers with 10 patients have shown that this approach is feasible in man, too. It appears that 5 × 108mononuclear cells/kg of body weight collected by seven or eight leukapheresis procedures of about 4 hrs each is sufficient for fast hemopoietic recovery after marrow ablative treatment. Potential advantages of the use of blood stem cells over bone marrow stem cells are the decreased likelihood of contamination with malignant cells, the avoidance of general anesthesia, and the infusion of immunocompetent cells, which might hasten immunorecovery in the autologous setti

ISSN:0733-2459    

DOI:10.1002/jca.2920030402

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractEffects of plasmapheresis on peripheral blood T‐cell, B‐cell, monocyte, and natural‐killer‐cell populations were studied in ten macroglobulinemia patients with hyperviscosity syndrome. Following plasmapheresis, there was a transient decrease in the number of T4 + helper cells and a longer‐lasting decrease in the number of Leu‐7 + natural killer cells and Mo2+ monocytes. In addition, there was a greater than 50% decrease in the in vitro ingestion capacity of monocytes. Although no significant changes in the numbers of IgM +, B1+, B4 +, or PCA + B cells (P>.05) were detected, there was a highly significant (P<.01) increase in I2 antigen density on the surface of IgM + B cells and in the bromodeoxyuridine uptake by these cells 7‐9 days after plasmapheresis. These findings suggest that following plasmapheresis, IgM+ B cells are activated. Using flow cytometry to determine when maximum IgM+ B cell activation occurs by measuring I2 antigen density on the cell surface may be useful in determining the postplasmapheresis timing of chemotherapy in macroglobulinemia patients with hyperviscosity syndrome who require more aggress

ISSN:0733-2459    

DOI:10.1002/jca.2920030403

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractLong‐term plasmapheresis (PP) therapy was studied in a 56‐year‐old patient with homozygous type IIa familial hypercholesterolemia also suffering from severe coronary heart disease. Three different PP techniques, plasma exchange (PE), double‐membrane‐filtration plasmapheresis (DFP), and the recently developed low‐density lipoprotein adsorbent column (adsorption plasmapheresis, adsorption PP), were used in an attempt to develop better means of managing the disease. All three techniques showed similar elimination efficiency with respect to plasma total cholesterol level. Adsorption PP with minimal supplemental plasma protein managed the circulatory status of the patient better than DFP during extracorporeal treatment. In the course of PP therapy xanthoma tuberosum markedly regressed, and the cardiac status of the patient was clear

ISSN:0733-2459    

DOI:10.1002/jca.2920030404

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA patient with juvenile rheumatoid arthritis whose disease was in remission during pregnancy underwent third‐trimester plasmaphereses. The stored plasma was returned to her 1 year postpartum, when the disease flared, without beneficial results. The literature on the use of blood products in rheumatoid arthritis and pregnancy is reviewe

ISSN:0733-2459    

DOI:10.1002/jca.2920030405

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractTen patients suffering from progressive systemic sclerosis, who responded poorly to conventional therapy, underwent plasma exchange (PE) therapy in conjunction with drug therapy. The frequency of PE was twice weekly for 4‐6 weeks, two or three times per year, with a summer interruption, when in our own experience a spontaneous relief of symptoms occurs. To judge the efficacy of our therapeutic device, we assessed several laboratory and clinical parameters before and after therapy. The changes in circulating immune complexes, in IgG and IgA, and in some functional indices were significant (P<0.001). Eight of 10 patients improved satisfactorily. The remaining two did not improve sufficiently to continue the apheretic treatment. In conclusion, our study suggests that the PE, together with conventional therapy, can be an effective therapeutic device in the treatment of progressive systemic sclerosi

ISSN:0733-2459    

DOI:10.1002/jca.2920030406

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThis report describes one case of rapidly progressive glomerulonephritis associated with amyloidosis in a 53‐year‐old woman with rheumatoid arthritis, successfully treated with intensive plasma exchange and immunosuppression. Amyloid deposits were present in all of 20 glomeruli in the kidney biopsy specimen and eight out of nine nonfibrosed glomeruli contained crescents. With intensive plasma exchange and immunosuppressive drugs, renal function improved, and hemodialysis was discontinued. After 2 years, renal function was stable at a moderate level of impairment, but heavy proteinuria persis

ISSN:0733-2459    

DOI:10.1002/jca.2920030407

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractTo evaluate the risk of significant plateletpheresis‐induced thrombocytopenia in normal volunteer donors undergoing plateletpheresis less frequently than every 56 days and to help understand factors influencing platelet yield in these donors, pre‐ and postapheresis platelet counts (×103/μl) and platelet yields were analyzed from 916 plateletpheresis procedures (Fenwal CS‐3000) on 607 donors (405 men, 202 women). The mean preaphresis platelet count was 265 ± 59 (SD) (range 155‐650) (men 256 ± 55 [170‐444]; women 284 ± 65 [155‐650];P<.001,t‐test). After an average platelet yield of 4.08 × 1011, the mean postplatelet count was 185 ± 46 (range 72‐420) (men 184 ± 42 [80‐345]; women 194 ± 52 [72‐500];P<0.1). The percent decrease in platelet count (mean 29.4 ± 13, range −28.1‐65.5) had positive correlations with platelet yield (P<.01, r = 0.10), predonation platelet count (P<.001, r = 0.29), and age (P<.01, r = .10) and a negative correlation with weight (P<.001, r = 0.18) Both the percent decrease and platelet yield were significantly higher in women than in men (P<.001,t‐test), and platelet yield was best predicted by preapheresis platelet count in both sexes (r = 0.65). The effects of plateletpheresis on donor platelet count thus vary widely among donors. Although a decrease of greater than 50% was not a rare event (5.9% of all procedures), in only three instances (0.3%) was the actual postapheresis platelet count below 100 (72, 94, 95). Thus, plateletpheresis in normal donors appears unlikely to produce clinically significant thrombocy

ISSN:0733-2459    

DOI:10.1002/jca.2920030408

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe practice of multiple use of membrane plasmafilters was examined in six patients receiving intermittent or regular plasmapheresis treatment. The plasmafilters were cleaned by flushing and ultrafiltration using positive pressure in the blood and filtrate compartments of the plasmafilter. Twenty‐six plasmafilters were studied and the membrane permeability characteristics were examined during 56 plasmapheresis treatments with reused plasmafilters. The clearances of nitrogen urea and creatinine, and the sieving coefficients of albumin and immunoglobulins remained unchanged with the reuse of plasmafilters. The practice is safe, efficient, and can contribute to cost containment in plasmapheresis treatmen

ISSN:0733-2459    

DOI:10.1002/jca.2920030409

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractWith cascade filtration (CF) secondary filter plugging may render some procedures difficult, particularly with cryoglobulinemia or macroglobulinemia patients, when filters are subjected to the most consistent burden. To prevent plugging, in the initial management of seven patients with cryoglobulinemia or macroglobulinemia we employed polymethylmethacrylate secondary filters produced by Toray Industries Inc., Tokyo, with pores calculated at 0.1 μm (QS‐12‐70). In the subsequent sessions, when circulating macroproteins were reduced to more acceptable levels, secondary filters with pores of 0.06 μm were used (QS‐12‐50). The filtration efficiency of both filters was maintained throughout the procedures with reverse rinses carried out when the transmembrane pressure from the values of 80‐130 mm Hg reached the values of 250 mm Hg. With this improved technique, 2.6‐3.31 liters of plasma could be treated, producing adequate clinical benefits. From a laboratory point of view, the differential sieving for albumin and macroglobulins was 61% for the QS‐12‐50 filters and 56% for th

ISSN:0733-2459    

DOI:10.1002/jca.2920030410

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920030411

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY