ISSN:0733-2459    

DOI:10.1002/jca.2920050103

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractA 61‐year‐old man was found to have small‐cell lung cancer following a 1‐year history of a progressive peripheral sensorimotor neuropathy. The neuropathy initially improved following chemotherapy, but subsequently progressed to the point of respiratory failure. Treatment with plasma exchange, additional chemotherapy, and radiotherapy resulted in a sustained complete tumor remission and neurologic recovery. The role of plasma exchange is unclear, but its use should be considered in cases of severe sensorimotor neuropathy unresponsive to antineoplastic tr

ISSN:0733-2459    

DOI:10.1002/jca.2920050104

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractThere is evidence that leukocyte contaminating red blood cells and platelet concentrates are responsible for refractoriness to platelet transfusions. The efficacy of a cotton‐wool filter to remove leukocytes from red blood cells has been documented previously. The present study was designed to evaluate whether the cotton‐wool filters can effectively remove leukocytes from platelet concentrates. Sixty pools of random‐donor platelets and single‐donor plateletpheresis products were filtered through a cotton‐wool filter. The efficacy of filtration was determined by measuring the absolute numbers of leukocytes and platelets and subpopulations of mononuclear cells. The average platelet loss was 8% per pool of random platelets and 10% per plateletpheresis product. The average leukocyte removal was 99% from a pool of random platelets and plateletpheresis concentrates collected by CS‐3000 and 90% from plateletpheresis concentrates harvested by single‐stage COBE/IBM‐2997. The filtration removed 100% of granulocytes, 95% of monocytes, 90% of B‐lymphocytes, and 85% of T‐lymphocytes. We conclude that filtration through a cotton‐wool filter is an efficient and cost‐effective method for preparation of l

ISSN:0733-2459    

DOI:10.1002/jca.2920050105

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractResearch in adoptive immunotherapy such as lymphokine‐activated killer cell (LAK) generation requires a large number of mononuclear cells (MNCs). The original procedure for generation of LAK cells used a Ficoll‐Hypaque (FH) purification of the MNCs collected by a blood separator to remove granulocytes, platelets, and red blood cells. Since the Fenwal CS 3000 blood separator produces MNCs with reduced granulocyte contamination, it is possible that FH purification could be replaced by a light centrifuge spin (LS) purification. We report on a study comparing the MNC recovery, platelet and red cell removal, purification time, in vitro LAK cytotoxicity, and phenotypic characterization of the lymphocytes, collected by FH purification vs. LS purification by using the CS 3000. Six donors were leukapheresed with the CS 3000 using a shortened LAK Cell procedure. Following an LS (3 minutes at 1,000 rpm), the MNC collection was divided into two equal aliquots, one aliquot purified by FH and the other aliquot purified by LS. Both aliquots were then washed, cultured for 5 days in IL‐2, and harvested with the CS 3000. Our findings suggest the LS purification resulted in improved 1) postpurification MNC recovery (89% vs. 60%), 2) purification time (54 minutes vs. 129 minutes), and 3) LAK cell generation by phenotype. LS purification was similar to FH purification in 1) platelet removal and 2) in vitro LAK cytotoxicty. We found the LS superior to FH when considering efficiency, economics, simplicity, and LAK cell genration and comparable in platelet removal and in vitro LAK cytotox

ISSN:0733-2459    

DOI:10.1002/jca.2920050106

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractPlasmapheresis has been shown to reduce total and free bilirubin levels in acute exacerbations of Crigler‐Najjar syndrome, type 1 (CNS‐TI), but its effectiveness in long‐term management has not been reported. An 18‐year‐old (yo) male with CNS‐TI, who required prolonged daily high‐intensity phototherapy to prevent cerebral nervous system symptoms, developed increasingly frequent bouts of confusion, nausea, and vomiting associated with free bilirubin concentrations (fbcs)>10–15 nmol/L. Pending consideration of orthotopic liver transplantation, plasma exchange (∼3 liters per procedure) was begun in 12/84 using the IBM/COBE 2997 with 5% albumin as replacement fluid. Frequency of treatments was guided by twice weekly fbcs, with plasma exchange for fbc>10–15 nmol/L. Pre‐exchange and postexchange fbcs ranged from 27.5 to 11 nmol/L and 9.2 to 2 nmol/L, respectively. Seventy‐two exchanges were performed over a 28 month period. Irreversible CNS damage did not occur, and the patient underwent successful liver transplantation in April of 1987, with complete correction of his metabolic disorder. He remains well 18 months fo

ISSN:0733-2459    

DOI:10.1002/jca.2920050107

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractAlthough therapeutic hemapheresis has grown dramatically in the past decade, its utilization and popularity in pediatrics remain limited. The lack of well‐defined indications for treatment and technical difficulties in the management of hemapheresis for small patients have prevented its widespread use. However, there have been more than 130 reports describing the use of hemapheresis in children less than 15 years of age, including more than 20 reports describing it in children less than 5 years. Only one controlled trial of hemapheresis in children has been published. It studied the use of plasma exchange for the treatment of diabetes mellitus.In general, practitioners depend upon the accepted indications in adults to justify usage of this therapy in children. Unfortunately, major differences exist in the adult and pediatric presentation of certain diseases and there has not been universal acceptance of the indications for this therapy in children.Numerous technical difficulties continue to plague the development of hemapheresis therapy in pediatrics and therefore continue to limit the number of studies undertaken. The major technical difficulties include vascular access and excessive extracorporeal volume. These problems are not insurmountable since several patients less than 1 year of age have been successfully treated by hemapheresis. The various techniques used in these cases will be discussed.Additional problems unique to the pediatric population are the difficulty in getting approval for research studies that involve minors, the complexity of informed consent, the problem of patient cooperation and compliance, and the difficulty of explaining a complicated procedure to children of varying developmental levels. Although there are a few detailed studies, complications in the treatment of pediatric cases are usually a combination of technical problems and untoward reactions, and it is difficult to compare these studies with those published involving adult patient

ISSN:0733-2459    

DOI:10.1002/jca.2920050108

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractNeonates are unusually susceptible to severe bacterial infections. Antibiotic therapy has been supplemented with granulocyte transfusions (GTX) to treat neonatal infections. The precise role of GTX to treat neonatal sepsis is controversial, and 11 reports (including six controlled studies) were critically analyzed. When all data are combined, 79% of 78 neonates receiving antibiotics plus GTX survived vs. 62% of 90 infants treated only with antibiotics. Among the six controlled trials, four found significantly better survival for neonates given GTX plus antibiotics. However, each of these trials can be criticized (few subjects, heterogeneous patients, defective design, inadequate granulocyte product, etc.). Although firm recommendations for GTX cannot be made currently, it seems reasonable to combine them with antibiotics to treat septic neonates that exhibit neutropenia for age and evidence of a diminished neutrophil marrow storage pool. Once the decision to transfuse is made, neonates should receive a minimum dose of 1 × 109fresh neutrophils per kg per transfusion

ISSN:0733-2459    

DOI:10.1002/jca.2920050109

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractSince the first case of AIDS was diagnosed in 1982, there have been over 2,300 cases, as of February 1989, in Canada. The epidemiological pattern of the cases in Canada follows that of the United States with the exception of intravenous drug users.In 1983, the federal government created a National Advisory Committee which is active in advising the Minister of National Health and Welfare on issues for the control and management of AIDS in Canada. In 1985, a $39 million program was announced. An enhanced program of AIDS control was established in July of 1987 with the creation of the Federal Center for AIDS (FCA). This has involved a substantial increase in financial and personnel resources.Canada plays a significant role internationally vis‐à‐vis AIDS; $10 million has been provided to the World Health Organization. The FCA is a WHO Collaborating Centre. In June of 1989, Canada will host the Vth International Conference on AIDS in Mont

ISSN:0733-2459    

DOI:10.1002/jca.2920050110

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920050111

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920050112

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY