Anatole Lubenko

Single hospital experience of TRALI

BACKGROUND: TRALI is a serious adverse effect of blood transfusion. There is evidence that the condition is underrecognized and underreported.

The low‐incidence MNS antigens Mv, sD, and Mit arise from single amino acid substitutions on GPB

BACKGROUND: GPB carries ‘N’ at its N‐terminus and S and s, determined by a polymorphism at amino acid position 29 (Met29Thr). The low‐incidence antigens Mv, sD, and Mit are associated with weakened expression of S and/or s, and the purpose of this study was to define their molecular bases.

Clinical grade OK432-activated dendritic cells: In vitro characterization and tracking during intralymphatic delivery

Dendritic cells (DC) are under intense preclinical and early clinical evaluation for the immunotherapy of cancer. However, the optimal culture conditions and route of delivery for DC vaccination have not been established. Here we describe the first human application of DC matured with the bacterial agent OK432 (OK-DC), using a short-term serum-free culture protocol, which generates mature DC from CD14+ precursors after 5 days. These cells were prepared within the framework of a National Blood Service facility, demonstrating that DC represent a product which is potentially deliverable alongside current standardized cell therapies within the UK National Health Service. In vitro analysis confirmed that OK-DC were mature, secreted tumor necrosis factor-α, interleukin-6, and interleukin-12, and stimulated both T cell and natural killer cell function. To explore effective delivery of OK-DC to lymph nodes, we performed an initial clinical tracking study of radioactively labeled, unpulsed OK-DC after intralymphatic injection into the dorsum of the foot. We showed that injected DC rapidly localized to ipsilateral pelvic lymph nodes, but did not disseminate to more distant nodes over a 48-hour period. There was no significant toxicity associated with OK-DC delivery. These results show that OK-DC are suitable for clinical use, and that intralymphatic delivery is feasible for localizing cells to sites where optimal priming of innate and adaptive antitumor immunity is likely to occur.

Screening for WBC antibodies by lymphocyte indirect immunofluorescence flow cytometry: superior to cytotoxicity and ELISA?

BACKGROUND: Cytotoxic WBC antibodies are found in patients who have refractoriness to platelet transfusion (RPT) or are experiencing febrile transfusion reactions (FTRs) and in sera giving so called nonspecific hemagglutination by IAT (N/S IAT). Sera from such patients were screened for WBC antibodies regardless of the ability to fix complement using a flow cytometric (FC) lymphocyte indirect immunofluorescence test (LIFT) to compare FC‐LIFT with a routine lymphocytotoxicity test (LCT) for WBC antibody detection.

The incidence of hemolytic disease of the newborn attributable to anti-Wra.

phenotype (synonyms “D mosaic,” “partial D,” “D deletion,” “epitope-deficient cells,” and “category cells”) is usually recognized only when the individual produces anti-D. Recognition of weak D samples depends on the methods and reagents used for Rh typing. With the increasing sensitivity of both, fewer Rh-positive samples will be categorized as D”. Some of the automated blood typing systems can detect, without using an indirect antiglobulin test for the Du phenotype, weak D samples that were previously detectable only by such a test. These samples are labeled as Rh positive. Many previously weak D samples react unequivocally on manual direct testing with some of the monoclonal antibody-based reagents and, therefore, are classified as Rh positive. Donor samples that are tested for the D“ phenotype by the indirect antiglobulin test and found to be positive must be labeled Rh positive to comply with the standardss of the American Association of Blood Banks, regardless of whether the term “D“” or “weak D” is used to describe them. When testing patients, many practitioners have already eliminated the test for the D‘ phenotype. With today’s anti-D reagents, only a small number of samples that fail to react on initial testing will subsequently react in the test for that phenotype. Changing the designation of a patient’s sample from “D”” to “weak D” does not alter the recommendation to transfuse Rh-positive blood to the patient, nor does it alter the management of a pregnant woman or a woman recently delivered of a child, in terms of whether to administer Rh immune globulin. (The AABB standards state that obstetrical patients who are D positive or Du should be considered Rh positive.) Wider use of the designation “weak D” for all weak expressions of the D antigen would eliminate much of the confusion caused by inconsistent and sometimes erroneous terminology. Red cells would be typed as D positive or D negative on direct testing, and, on this basis alone, the individual would be described as Rh positive or Rh negative. Persons known previously as D‘ may now be referred to as “weak D” or simply as Rh positive, depending on how their red ells react with the particular anti-D reagent used for Rh typing.