Keisuke Nagamine

Immature platelet fraction (IPF) as a predictive value for thrombopoietic recovery after allogeneic stem cell transplantation

We consecutively examined the utility of measurements of percentage of immature platelet fraction (IPF%) and absolute IPF number (A-IPF) in predicting thrombopoietic recovery in 15 adult patients who underwent allogeneic hematopoietic stem cell transplantation (allo-SCT). Four patients were excluded from the evaluation due to insufficient data. Platelet count and IPF were measured by Sysmex XN-1000 (XN), a newer generation analyzer. First, we confirmed that platelet count measured by XN was more accurate than by XE-2100 (XE). IPF measurement was effective to predict the recovery in 7 of the 11 patients examined. Moreover, IPF measurement, especially IPF% measurement, suggested accelerated platelet turnover in two patients who failed to achieve platelet recovery by day 60. In addition to IPF%, A-IPF showed a complementary role on the prediction of thrombopoietic recovery. The increase in IPF% was only transient, while A-IPF values showed lasting increase during platelet recovery. In two patients (cases 6 and 7) an increase in A-IPF, but not in IPF%, was observed during platelet recovery. Our data suggest that IPF% and A-IPF measured by XN are useful for the prediction of thrombopoietic recovery and the assessment of pathogenesis of thrombocytopenia in patients after allo-SCT.

Distinct effects of daratumumab on indirect and direct antiglobulin tests: a new method employing 0.01 mol/L dithiothreitol for negating the daratumumab interference with preserving K antigenicity (Osaka method): 0.01 MOL/L DTT FOR THE DARA INTERFERENCE

There is an increasing demand for daratumumab (DARA), an immunoglobulin (Ig)G1κ monoclonal antibody (MoAb) that recognizes CD38, to manage relapsed or refractory multiple myeloma (MM) patients. However, DARA leads to positive and panreactive agglutination reactions in indirect antiglobulin tests (IATs) in vitro (the DARA interference). In addition, effects of DARA on red blood cells (RBCs) in vivo remains elusive.

Report on ABO-Incompatible Transfusions in 12 University Hospitals in Kinki Districts.

We investigated the incidence and the causes of ABO-incompatible transfusion in 12 university hospitals in the Kinki district during the 5-year period from 1993 through 1997. Over 5 years, 648, 553 units of red cell components (RBC) and 2, 545, 880 units of fresh frozen plasma (FFP) or platelet concentrate (PC) were transfused, and a total of 26 ABO-incompatible transfusions occurred. Incompatible RBC were transfused to 17 patients and FFP or PC were transfused to the remaining 9 patients. In cases of RBC transfusion, half of errors (8 cases) were due to misidentification of blood units and the other half of errors (8 cases) were due to incorrect typing. Twenty of 26 errors occurred during night shifts and the majority of errors occurred in the ward (17 cases) or operating room (5 cases). Various measures were taken to prevent ABO-incompatible transfusion at the participating universities. We conclude that continued data collection and analysis are necessary to prevent ABO-incompatible transfusion.

A case of immune hemolytic anemia due to "auto" anti-A1 antibody induced by group O homograft in renal transplantation recipient.

A case of severe auto-immune hemolytic anemia after a living, ABO-incompatible renal transplantation is reported.The recipient, a 34 years old man, blood group A1, Rh0 (D) positive receieved a renal transplant from father whose blood group O, Rh0(D) positive donor. Cyclosporine, prednisolone and mizoribine were used for immunosuppresion.The recipient devloped severe immune hemolytic anemia within 2 weeks of renal transplantation. The recipients serum contained anti-A1 IgG autoantibody and anti-B IgG antibody on day 18 post-transplantation. The IgG subclass of these antibodies was IgG3.

ELISA for detection of red cell antibodies using red cell ghosts coated plates. The detection of Rh and other antibodies.

An ELISA using micro-plates coated with red cell ghosts was developed for analysis of red cell antibodies.Antibodies against MNSs, Kell, Duffy and Kidd antigens were detected using this ELISA. Rh antibodies in patients sera could be also detected by this assay, but the elution technique was needed when the titer of antibody was low.We considered that this assay was quantitative, objective and sensitive compared with indirect antiglobulin test, and easy to perform compared with ELISA of tube method using red cell suspensions.