摘要:

AbstractWe describe our experience in processing 40 bone marrow aspirates harvested for autotransplantation from patients with several hematological diseases using the CS‐3000 blood cell separator. The bone marrow of the first 30 patients was processed by a semiautomated method, and a fully automated procedure was used for the remaining 10 cases.Both procedures were developed in our laboratory and yielded a similar average mononuclear cell recovery of 87.78% and 86.98%, respectively, and similar nucleated cell recovery (27.39% and 27.11%). The cloning efficiency of hematopoietic progenitor cells, measured as the total CFU‐GM colony recovery in the in vitro cultures, did not differ between processed and recovered mononuclear cells. On the other hand, all the patients with transplants showed complete hematologic recovery, and the time to engraftment was similar to that described for other procedures. The automated procedure resulted in an average red cell removal of 97.81%, similar to the semiautomated procedure (94.19%), though with a narrower range (96.31–98.6% vs. 80.34–98.34%). The time taken to process a similar amount of bone marrow cell suspension was very different for each method: 1 hour for the fully automated vs. 2 1/2 hours for the semiautomated method to process 1.000 ml. Furthermore, the semiautomated procedure required the addition of homologous or irradiated plasma in a laminar air flow chamber, while the automated method is performed in a closed sterile system. We conclude that our procedure using the CS‐3000 processor is an efficient method for fully automated large‐scale processing of human bone marrow cells. © 1992 Wil

ISSN:0733-2459    

DOI:10.1002/jca.2920070302

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

摘要:

AbstractA relationship is described between the interaction of circulating immune complexes (CIC) from plasma with staphylococcal protein A immunoadsorption treatment columns and modulation of antibody responses related to the specific CIC. Eluates from the initial immunoadsorption columns used to treat a series of patients with breast adenocarcinoma, cancer chemotherapy‐associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (C‐TTP/HUS), or immune thrombocytopenic purpura (ITP) were evaluated for disease‐specific CIC containing Lexglycosphingolipid (Lexgl) adenocarcinoma‐associated antigens or platelet autoantibody (anti‐GPIIb/IIIa), together with the corresponding neutralizing antibody [anti‐F(ab′)2], and for nonspecific CIC containing cytomegalovirus (CMV) or herpes simplex virus type 1 (HSV‐1) antigens. In addition, the levels of antibodies directed against CMV, HSV‐1. Lexgl, and GPIIb/IIIa antigens, as well as anti‐F(ab′)2antibodies, were compared in pretreatment and posttreatment serum samples.Columns used to treat breast adenocarcinoma patients contained only Lexgl CIC, and the only immunologic change observed after treatment was significant increases in anti‐Lexgl antibodies in some patients. Columns used to treat C‐TTP/HUS patients contained anti‐GPIIb/IIIa‐anti‐F(ab′)2CIC, in addition to Lexgl CIC. After treatment, significant increases in anti‐Lexgl and anti‐F(ab′)2antibodies and significant decreases in anti‐GPIIb/IIIa antibodies were observed in some patients. Columns used to treat ITP patients only exhibited anti‐GPIIb/IIIa‐anti‐F(ab′)2CIC, and after treatment only decreases in anti‐GPIIb/IIIa and increases in anti‐F(ab′)2antibodies were observed in some patients. None of the treatment columns exhibited CIC with CMV or HSV‐1 antigens, and no effects on pretreatment levels of anti‐CMV or anti‐HSV‐1 antibodies were observed in any patients posttreatment. Immunologic responses were correlated closely with clinical responses in each group of patients. The study showed that neither stimulation nor depression of antibody responses occurred in the absence of an interaction of corresponding specific CIC with the matrix. The results suggest that nonspecific stimulation of a variety of antibody responses is not the usual mechanism by which clinical responses to protein A

ISSN:0733-2459    

DOI:10.1002/jca.2920070303

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

摘要:

AbstractWe retrospectively analyzed our 2‐year experience with venous access for 363 therapeutic plasma exchanges in 46 patients with neurological disease, including acute Guillain‐Barré syndrome (N = 20), myasthenia gravis (N = 17), and chronic inflammatory demyelinating polyneuropathy (N = 9). Twenty‐three patients (50%) completed the planned course of therapy using only peripheral venous access, and 28 central venous catheters were placed in the remaining 23 patients. Patients utilizing central venous access did not undergo a greater number of procedures, but they were more likely to have acute Guillain‐Barré syndrome (P<0.02) or to be hospitalized in a medical intensive care unit (P<0.01). Three types of central catheters were used, and although our experience was predominantly with 1 type, differences were noted. Only 3% of procedures (3 of 96) done with a Quinton‐Mahurkar catheter were associated with a catheter failure, compared to 27% (4 of 15,P<0.01) with a Hickman catheter and 67% (2 of 3) with a triple‐lumen catheter. Life‐threatening complications occurred with 3 of 28 (11%) central catheters. To optimize the success of therapeutic plasma exchange using central access, it is critical that hemapheresis personnel advise each patient's primary physician regarding the type of central venous catheter required. Currently, we recommend use of a Quinton‐Mahurkar or other dual‐lumen hemodialysis catheter. ©

ISSN:0733-2459    

DOI:10.1002/jca.2920070304

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920070305

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

摘要:

AbstractHematopoietic stem cells circulate in the peripheral blood. These cells can be collected by apheresis techniques either in the unperturbed state, after mobilization following the administration of cytokines like G‐CSF or GM‐CSF, or during the phase of early blood count recovery following chemotherapy‐induced myelosuppression. The number of cells collected following mobilization is greater than that obtained after apheresis in the unperturbed state. There are, however, qualitative differences between unperturbed and mobilized cells. Chemotherapy related mobilization can be potentially dangerous in that severe myelosuppression necessary to achieve mobilization can have serious consequences. There are no controlled studies that evaluate the relative merits of each method of collection. Regardless of the techniques employed peripheral blood stem cells can reliably accelerate hematologic recovery after potentially myeloblative therapy and provide an alternative to bone marrow support. © 1992 Wiley‐L

ISSN:0733-2459    

DOI:10.1002/jca.2920070306

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

摘要:

AbstractEither bone marrow or peripheral blood may be harvested to provide hematopoietic stem cells (HSC) for autologous transplantation. Both, however, comprise heterogeneous cell populations. The HSC necessary for successful engraftment constitute a very small fraction of the cells harvested. After collection, the harvested cells usually undergo several processing steps to reduce the product volume, remove cells (such as mature blood cells or tumor cells), or to cryopreserve the cells for later reinfusion. Granulocytes and red blood cells, for example, survive cryopreservation poorly using freezing techniques designed for HSC. Therefore, bone marrows being cryopreserved must be depleted of mature blood cells to avoid toxicity from infusion of damaged mature blood cells. Mature blood cells may also impede the variety of tumor cell purging techniques currently being studied. These processings are designed to minimize the loss of HSC while achieving an appropriate HSC product for the individual patient. A number of apheresis devices and cell washers simplify the enrichment of HSC in the harvested cell products. In contrast, tumor cell purging techniques are not standardized between the various transplant centers. © 1992 Wiley‐Liss, I

ISSN:0733-2459    

DOI:10.1002/jca.2920070307

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920070308

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

摘要:

AbstractBone marrow transplantation is an increasingly important therapeutic procedure. As more laboratories have become involved in the processing of hematopoietic progenitor cells from marrow or blood, it has been recognized that standards are required for hematopoietic progenitor processing, storage, and handling. Quality assurance is the process of monitoring whether laboratory procedures, equipment, and personnel fulfill their expected functions, and the aim of quality assurance is to ensure compliance with standards. Some standards for hematopoietic progenitor processing have recently been issued by professional organizations. Although these standards are not comprehensive, where applicable they should be met or exceeded. In the absence of published standards, principles of good laboratory practice should guide quality assurance programs. This article, presents concepts of quality assurance in hematopoietic progenitor processing, based on standard laboratory practice and published standards. © 1992 Wiley‐Liss, I

ISSN:0733-2459    

DOI:10.1002/jca.2920070309

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920070310

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920070311

出版商:John Wiley&Sons, Inc.    

年代:1992

数据来源: WILEY