Erol Ayyildiz

Comparison of different needle diameters and flow rates on bone marrow mononuclear stem cell viability: an ex vivo experimental study.

Considerable information is available regarding the experimental and clinical applications of bone marrow derived stem cells (BMDSC) for regenerative medicine. Optimized stem cell delivery systems might help to maintain better stem cell viability. We have investigated whether needle diameters and flow rates through the needles cause any difference in terms of BMDSC viability.

Plerixafor use in patients with previous mobilization failure: A multicenter experience

Plerixafor in conjunction with G-CSF (G-P) is an effective strategy for hematopoietic stem cell mobilization in patients with previously failed mobilization attempt. Here we report our results with G-P among patients with at least one mobilization failure with G-CSF alone (G) or G-CSF plus chemotherapy (G-C). The study included 20 consecutive patients with lymphoma and myeloma from five centers. In 14 (70%) patients, a minimum of 2×10(6)/kg CD34+ stem cells were collected and 16 out of 20 patients (80%) were able to proceed to ASCT. Our study indicates that plerixafor can safely rescue patients with a history of mobilization failure.

Therapeutic plasma exchange in an intensive care unit (ICU): A 10-year, single-center experience

Therapeutic plasma exchange (TPE) is a blood purification method that effectively allows for the removal of waste substances by separating out plasma from other components of blood and the removed plasma is replaced with solutions such as albumin and/or plasma, or crystalloid/colloid solutions. Plasma exchange therapies are becoming increasingly essential, being used in daily practice in critical care settings for various indications, either as a first-line therapeutic intervention or as an adjunct to conventional therapies. This retrospective clinical study analyzes 10-year therapeutic plasma exchange activity experience in an 18-bed ICU at a tertiary care university hospital with a large, critically-ill patient population. Medical records of 1188 plasma exchange procedures on 329 patients with different diagnoses admitted from January 2000 to July 2010 were evaluated. The aim of the study was to determine the TPE indications and outcomes of the patients who underwent TPE in the ICU with conventional therapy. The secondary endpoints were to determine the differences between different patient groups (septic vs. non-septic indications) in terms of adverse events and procedural differences.

Double filtration plasmapheresis for a case of Crimean-Congo hemorrhagic fever

Crimean-Congo hemorrhagic fever (CCHF), is a fatal viral infection transmitted to humans through a tick bite or exposure to blood or tissues of viremic hosts. The clinical presentation is characterized by sudden onset high fever, headache, myalgia, abdominal pain and nausea-vomiting followed by gastrointestinal, urinary, respiratory tract and brain hemorrhage. Laboratory findings include leucopenia, thrombocytopenia, elevated liver enzymes, prolonged prothrombin time and activated partial thromboplastin time. We report a case of CCHF who was treated with a combination of DFPP and ribavirin therapy. As a result of this multimodal treatment, patients clinical symptoms and laboratory findings improved gradually.

Impact of age and diagnosis on viability during centrifugation and cryopreservation of peripheral blood stem cell products

BACKGROUND The viability of the hematopoietic stem cells infused to the patient is important for transplant outcome. STUDY DESIGN AND METHODS We evaluated 31 peripheral blood stem cell product collected from 15 patients. We aimed to check the viabilities of the cells from patients with different age and diagnosis, in different stages of the cryopreservation procedure. RESULTS We showed a markedly decreased viability rate after centrifugation and addition of DMSO. Percentages of viabilities were similar between young and old patients in each step. Type of hematological malignancy did not make a significant influence on the viability. CONCLUSION High speed centrifugation has a negative impact on the viability.

Older age and capacity of colony forming unit in autologous peripheral derived hematopoietic cells.

BACKGROUND Aging decreases bone marrow cellularity and alters the frequencies of stem cells. Aged hematopoietic stem cells can differ from their younger counterparts in functional capacity. STUDY DESIGN AND METHODS We aimed to evaluate the relation between the age and the ability of colony forming capacity of peripheral blood-derived hematopoietic cell products collected for autologous stem cell transplantation (AHSCT). RESULTS Elderly patients could be mobilized with lower total collected CD34+ cells. Colony forming capacity did not differ between young and old patients. CONCLUSION This results can be translated into clinic as higher numbers of AHSCT candidates over age 60.

Therapeutic plasmapheresis in geriatric patients: favorable results.

Therapeutic plasma exchange is generally a tolerable procedure, although several complications should be considered. Since geriatric population has been growing worldwide, the aim of this study was to retrospectively analyze 4709 TPE data from 981 geriatric procedures (20.8%) and to compare them with 3728 non-geriatric procedures (79.2%). The most common indications for TPE in both groups were sepsis/adult respiratory distress syndrome and multiple organ dysfunction. In geriatric patient group, contrary to expectations of aggravation, complication rate was statistically similar with non-geriatric group (P > 0.05). Therefore, TPE appeared to be a safe procedure in geriatric patients when performed by experienced practitioners.

The effect of CD34 count and clonogenic potential of hematopoietic stem cells on engraftment

In this study we have determined that the number of the CD34 (+) cells in the grafts that were infused to 48 patients who underwent autologous and allogeneic hematopoietic cell transplantation and evaluated the number of colony forming units in vitro. Our aim was to determine whether there is a relation between these cell counts and post transplantation engraftment kinetics. A negative correlation was detected (p<0.05) between the CD34 (+) cell count and all colony forming units. A correlation between the CD34 (+) cell count and the kinetics of engraftment could not be demonstrated. In the autologous group, only a weak negative correlation between the CFU-GEMM and neutrophil engraftment was detected. In the allogeneic group, colony forming units did not determine the engraftment.

O-21 DOUBLE FILTRATION PLASMAPHERESIS IN THE MANAGEMENT OF A CRIMEAN-CONGO HEMORRHAGIC FEVER CASE

regular LDL-apheresis therapy and to factors related to low compliance. We analysed 12,269 prescribed procedures of LDL-apheresis performed between 1990 and 2007 in patients with familial hypercholesterolemia (n =51). Regular LDL-apheresis treatment was initiated in patients presenting with either homozygous familial hypercholesterolemia (n =29), or severe heterozygous familial hypercholesterolemia (n =22) with elevated LDL-cholesterol levels and who did not respond adequately to diet and drug therapy; the majority of these patients (n = 29) presented cardiovascular disease at initiation of therapy. Results: The overall observed compliance rate based on the number of achieved/programmed procedures was 87.6%. Neither cardiovascular history nor subtypes of hypercholesterolemia were associated with compliance. In addition, there was no impact of patient demography on compliance. Treatment frequency alone significantly impacted noncompliance (i.e. patient with weekly procedures are less compliant). Interestingly, a no significant fall in compliance was evident among patients aged <20 years. Conclusion: Despite the complexity of the LDL-apheresis procedure and its impact on the organisation of our patients’ daily lives, overall compliance was very high. The choice of an appropriate and adequate frequency of treatment significantly impacted patient compliance.