Derwood Pamphilon

Practical Transfusion Medicine

Practical transfusion medicine , Practical transfusion medicine , کتابخانه دیجیتال جندی شاپور اهواز

The use of granulocyte–colony-stimulating factor in volunteer unrelated hemopoietic stem cell donors

Granulocyte–colony‐stimulating factor (G‐CSF) is used for the mobilization of hemopoietic stem cells in healthy donors. It has a number of common side effects such as bone pain, which resolve rapidly after administration is discontinued. Recent publications have raised concern that it might act as a trigger for the development of hematologic malignancy in susceptible individuals, possibly by causing genomic instability, but to date there is no evidence that healthy volunteer donors who receive G‐CSF are at any increased risk. Ongoing studies aim to confirm whether or not G‐CSF can cause chromosomal abnormalities in healthy donors. In the UK, the British Bone Marrow Registry and Anthony Nolan Trust give G‐CSF to donors who have agreed to donate peripheral blood stem cells. It is recommended by the UK Registries at present that all stem cell donors are given updated information explaining the current uncertainties with regard to the use of G‐CSF before they give informed consent to its administration. This information is based on a statement agreed by the World Marrow Donor Association for use by individual donor registries. Further, it is our current practice that all donors who have received G‐CSF, as well as marrow donors who do not, should be under regular review for at least 10 years to allow the occurrence of any long‐term adverse events to be documented.

Multiple-laboratory comparison of in vitro assays utilized to characterize hematopoietic cells in cord blood.

BACKGROUND:  Understanding the variability in results obtained by multiple laboratories is important because cord blood units are distributed worldwide for transplantation.

Hematopoietic growth factors—use in normal blood and stem cell donors: clinical and ethical issues

475. 99. Bussel JB, Kuter DJ, George LN, McMillan R, Aledort LM, Conklin GT, Lichtin AE, Lyons RM, Nieva J, Wasser JS, Wiznitzer I, Kelly R, Chen CF, Nichol JL. AMG 531, a thrombopoiesis-stimulating protein, for chronic ITP. N Engl J Med 2006;355:1672-81. 100. Kuter D, Bussel J, George J, Aledort L, Lichtin A, Lyons R, Nieva J, Wasser J, Bourgeois E, Kappers-Klunne M, Lefrere F, Schipperus M, Kelly R, Christal J, Guo M, Nichol J. Longterm dosing of AMG 531 in thrombocytopenic patients with immune thrombocytopenic purpura: 48-week update [abstract]. Blood 2006;108:144a, abstract #476. 101. McHutchison JG, Dusheiko G, Shiffman ML, RodriguezTorres M, Sigal S, Bourliere M, Berg T, Gordon SC, Campbell FM, Theodore D, Blackman N, Jenkins J, Afdhal NH; TPL102357 Study Group. Eltrombopag for thrombocytopenic in patients with cirrhosis associated with hepatitis C. N Engl J Med 2007;357:2227-36. 102. Spivak JL. Recombinant human erythropoietin and its role in transfusion medicine. Transfusion 1994;34:1-4. 103. Fullerton DA, Campbell DN, Whitman GJ. Use of human recombinant erythropoietin to correct severe preoperative anemia. Ann Thorac Surg 1991;51:825-6. 104. Gaudiani VA, Mason HD. Preoperative erythropoietin in Jehovah’s Witnesses who require cardiac procedures. Ann Thorac Surg 1991;41:823-4. 105. Shi PA, Ness PM. Two-unit red cell apheresis and its potential advantages over traditional whole blood donation: a review. Transfusion 1999;39:218-25. 106. Bahlmann FH, Groot K, Spandau J-M, Landry AL, Hertel B, Duckert T, Boehm SM, Menne J, Haller H, Fliser D. Erythropoietin regulates endothelial progenitor cells. Blood 2004;103:921-6. 107. Anagnostou A, Liu Z, Steiner M, Chin K, Lee ES, Kessimian N, Noguchi CT. Erythropoietin receptor mRNA expression in human endothelial cells. Proc Natl Acad Sci U S A 1994;

Viability does not necessarily reflect the hematopoietic progenitor cell potency of a cord blood unit: Results of an interlaboratory exercise

BACKGROUND: Clinical transplant outcome with umbilical cord blood (UCB) as source of hematopoietic progenitor cells (HPCs) is, among other factors, determined by the total number of viable nucleated cells and/or CD34+ cells in the unit. Quantitative and qualitative losses by processing and cryopreservation and by thawing and washing before transfusion may occur, however. Another reason for a discrepancy between the number of cells in the unit released by the cord blood bank and found in the transplant center may be technical differences in cell counting methods between the two sites.

Factors affecting volume reduction and red blood cell depletion of bone marrow on the COBE Spectra cell separator before haematopoietic stem cell transplantation

The COBE Spectra™ is used to volume/red blood cell (RBC) deplete BM before transplantation or cryopreservation. We have audited our results to identify the effect of transit time, refrigerated storage, age and cellular composition on mononuclear cells (MNC) and CD34+ cell recoveries, volume/RBC depletion and neutrophil engraftment. In total, 88 consecutive collections from autologous (n=25) and allogeneic (n=63) donors were included. The mean collection volume was 1250±398 ml with RBC content of 341±113 ml. The MNC and CD34+ cell recoveries were 83.3±18.5 and 88.1±18.9%, respectively, volume depletion was 88.2±4.4% and RBC depletion 98.3±1.8%. Neutrophil engraftment was achieved in 20.1±6.4 days. Factors affecting MNC and CD34+ cell recoveries were transit time (P=0.0060), overall age (P<0.0210) and MNC/CD34+ cell concentrations (P<0.0313). The presence of crenated RBC also reduced CD34+ cell recovery (P=0.0028). Refrigerated storage did not adversely affect cell recovery (P>0.8161) or neutrophil engraftment (P=0.8959). This study demonstrates that time in transit, overall age, MNC and CD34+ cell concentrations and RBC condition were important factors affecting processing. RBCs show artefacts soon after collection at ambient temperatures and these may interfere with the separation and collection of MNC/CD34+ cells. Refrigeration at 4–6°C during transit and storage may reduce formation of RBC artefacts and maximize MNC and CD34+ cell recoveries.

Therapeutic efficacy of pooled buffy‐coat platelet components prepared and stored with a platelet additive solution

Summary.  Despite the introduction of platelet additive solutions for the preparation of pooled platelet components, only a few studies of limited scope have evaluated the clinical efficacy of platelets stored in these solutions. The current report presents an analysis of data to evaluate the response to the transfusion of pooled buffy‐coat components suspended in storage solution with reduced (35%) plasma content in comparison with 100% plasma products.

Transportation of cellular therapy products: report of a survey by the cellular therapies team of the Biomedical Excellence for Safer Transfusion (BEST) collaborative

Background and Objectives  Most cell therapy products (CTP) are infused or processed shortly after collection but in some cases this may be delayed for up to 48 h. A number of variables such as temperature and cell concentration are of critical importance for the integrity of CTP during this time.

JACIE accreditation in 2008: demonstrating excellence in stem cell transplantation.

JACIE was initiated as a small pilot project in Spain in 2000 and launched as a formal Europe-wide inspection program in January 2004. Since 2000, over 150 applications for accreditation have been received by the JACIE Office and more than 130 inspections have been completed in European centers and facilities. Almost all of these were found to be functioning at a high level of excellence, with the majority having only minor deficiencies in compliance with the standards. In one-third of centers there were more significant deficiencies. The most common deficiencies were in quality management. Following correction of deficiencies 86 centers have to date achieved full accreditation and many more are nearing the completion of the process. Implementation of JACIE involves a significant investment of time and resources by applicant centers. The majority require at least 18 months to prepare for accreditation and 85% have needed to employ a quality manager and/or data manager on an ongoing basis. However, all centers felt their program had benefited from the implementation of JACIE. JACIE is also working closely with other international organisations related to cellular therapy as part of the Alliance for the Harmonisation of Cell Therapy Accreditation (AHCTA), which is examining the differences in existing standards and aiming to develop international standards for all aspects of stem cell transplantation. In particular the requirements for safety of imported tissues and cells has emphasised the need for global harmonisation. The recent implementation of Directive 2004/23/EC and the associated Commission Directives 2006/17/EC and 2006/86/EC has provided an impetus for the implementation of JACIE in European Union (EU) member states. It will be important in the future to examine how JACIE can co-operate with the EU Competent Authorities (CA) to ease the burden of the inspection process for haemopoietic stem cell (HSC) transplant programs.

Storage characteristics of cord blood progenitor cells: report of a multicenter study by the cellular therapies team of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative.

BACKGROUND: Most hematopoietic progenitor cell (HPC) products are infused or processed shortly after collection, but in some cases this may be delayed for up to 48 hours. A number of variables such as temperature and cell concentration are of critical importance for the integrity of HPCs during this time.