ISSN:0733-2459    

DOI:10.1002/jca.2920100302

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe literature pertaining to the use of granulocyte transfusions as treatment for progressive bacterial, yeast, and fungal infections in severely neutropenic patients is reviewed. Efficacy in treating bacterial infections that are unresponsive to antimicrobial therapy is well established—especially if bone marrow failure does not recover rapidly and neutropenia is persistent. The role of therapeutic granulocyte transfusions for yeast and fungal infections has potential merit, but current data are incomplete and findings are inconsistent. The possibility of greater success has been raised by use of recombinant granulocyte colony stimulating factor to greatly increase the yield of neutrophils collected from normal donor

ISSN:0733-2459    

DOI:10.1002/jca.2920100303

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe role of the blood bank in provision of an optimal granulocyte concentrate is discussed. The importance of the granulocyte dose is emphasized, and recent developments permitting the collection of larger numbers of cells are reviewed. In particular, the administration of granulocyte colony‐stimulating factor to normal donors has been reported to result in dramatically increased neutrophil yields. Recent data has also suggested that increased efficiencies of collection can be realized by the use of hetastarch as the red cell sedimenting agen

ISSN:0733-2459    

DOI:10.1002/jca.2920100304

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractTo halt bleeding in patients with severe thrombocytopenia due to bone marrow failure, it is desirable to achieve a post‐transfusion blood platelet count of 40 × 109/L by platelet transfusions. Based on calculations of corrected count increments, each 1 × 1011platelets transfused will increase the blood platelet count approximately 10 × 109/L per each square meter of patient body surface area. Thus, the post‐transfusion blood platelet count will be approximately 20 × 109/L following transfusion of 3 × 1011platelets to a 5 foot, 8 inch patient weighing 170 pounds (2.0 m2), who is bleeding because of a pre‐transfusion platelet count of 5 × 109/L. The post‐transfusion platelet count likely will be even lower in sick patients (sepsis, amphotericin B plus antibiotic therapy, splenomegaly, graft‐vs.‐host disease, etc.) or if platelets are lost from the unit by leukofiltration before transfusion. Although a dose of 3 × 1011platelets is acceptable, in a regulatory sense for product quality, it is inadequate to control bleeding in most thrombocytopenic adult patients. Adjusting dose for body size, bleeding patients with pre‐transfusion blood platelet of120 pounds should receive approximately 6 × 1011platelets, those weighing 30 to 120 pounds should receive 3 × 1011platelets, and infants weighing<30 pounds (15 kg) should receive 5–10 ml/k

ISSN:0733-2459    

DOI:10.1002/jca.2920100305

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractDuring the past two decades, an increased demand for platelets has challenged blood collection centers to produce a safe and readily available supply. Defining the ideal platelet for transfusion is a process that cannot be decided by a single entity. Collection centers are only one member of a partnership which involves the donor, transfusion service, hospital administration, clinicians, and patients. Regulatory definitions exist to help guide collection centers to the minimum acceptable criteria for the production of platelets, but in reality, the standard by which clinicians judge the efficacy of the product is most important.

ISSN:0733-2459    

DOI:10.1002/jca.2920100306

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractHarvesting of autologous peripheral blood stem cells (PBSCs) has been facilitated by using currently available, efficient apheresis technology at the time of rebound from chemotherapy while patients are receiving recombinant growth factors, i.e., granulocyte (G) or granulocyte‐macrophage (GM) colony stimulating factor (CSF). Ideally pheresis should be done before patients have had extensive stem cell toxins, i.e., alkylating agents or nitrosoureas. This strategy has facilitated the use of high dose chemoradiotherapy given as a single regimen or in a divided dose for patients with solid tumors or hematologic malignancies and results in more rapid engraftment than bone marrow transplantation (BMT). Although mere are no assays which measure repopulating stem cells, enumeration of CD34+cells within PBSCs is a direct and rapid assay which provides an index of both early and late long‐term reconstitutive capacity, since it correlates with colony‐forming unit (CFU)‐GMs, as well as pre‐progenitor or delta assays and long‐term culture‐initiating cells (LTC‐IC). A threshold of ≥2 × 106CD34+cells/kg recipient body weight has been reported to be required for engraftment, but may vary depending upon the clinical setting. Strategies for mobilization of normal PBSCs also increase tumor cell contamination within PB in the setting of both hematologic malignancies and solid tumors, but the significance of these tumor cells in terms of patient outcome is unclear. Recently isolation of CD34+cells from PBSCs has been done using magnetic beads or immunoabsorption on columns or rigid plates in order to enrich for normal hematopoietic progenitors and potentially decrease tumor cell contamination. As for other cellular blood components, standards have been developed to assure efficient collection and processing, thawing, and reinfusion, and to maintain optimal PBPC viability. Finally, future directions of clinical research include expansion of hematopoietic progenitor cells ex vivo; use of umbilical cord or placenta as rich sources of progenitor cells; syngeneic hematopoietic stem cell transplantation; related and unrelated allogeneic hematopoietic stem cell transplantation; treatment of infections, i.e., Epstein Barr virus, or tumor relapse after allogeneic BMT using donor PBSC infusions; and gene

ISSN:0733-2459    

DOI:10.1002/jca.2920100307

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractRecently, donor lymphocyte infusions have been successfully used to treat patients with CML who have relapsed following allogeneic bone marrow transplantation (BMT). Responses can be achieved in more than 60–70% of patients with stable phase CML without the need for the additional high dose cytotoxic chemotherapy that would accompany a second transplant procedure. The clinical and molecular remissions induced by this approach are a clear demonstration of graft‐versus‐leukemia (GVL) activity. Although undoubtedly donor lymphocyte infusions are safer than a second BMT, they are associated with toxicities stemming from graft‐versus‐host disease (GVHD) and pancytopenia. In this review, the immunomodulatory mechanisms underlying the GVL activity of donor allogeneic lymphocytes infusions are presented. Unresolved issues regarding lymphocyte administration are discussed as well as potential ways to limit complications due to GVHD and pancytopenia. New potential applications of this immunotherapeutic approach for treatment of infectious disease and non‐hematologic malignancies will b

ISSN:0733-2459    

DOI:10.1002/jca.2920100308

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe extracorporeal inactivation of a lymphocyte rich buffy coat suspension with ultraviolet A light and 8 methoxypsoralen can lead to dramatic clinical improvements following reinfusion of the damaged cells. This therapy is reviewed in the context of the disease it is most commonly used for: cutaneous lymphoma. Studies with cutaneous lymphoma patients have shown an active immune response against purified tumor cells. In addition a mouse model for an impact of therapy on a T‐cell lymphoma has demonstrated results that parallel those from clinical studies in humans. The impact of photoimmune therapy on in vivo and in vitro T‐cell responses to cutaneous lymphoma is discus

ISSN:0733-2459    

DOI:10.1002/jca.2920100309

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920100310

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920100311

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY