Malcolm R. MacKenzie

HLA class II antibodies in transfusion‐related acute lung injury

BACKGROUND: Transfusion‐related acute lung injury (TRALI) is a serious, sometimes fatal, complication of transfusion. Granulocyte and HLA class I antibodies present in blood donors have been associated with TRALI. HLA class II antibodies have recently been described in a few cases of TRALI.

TRALI: correlation of antigen-antibody and monocyte activation in donor-recipient pairs.

BACKGROUND : TRALI may be a severe reaction associated with transfusion of plasma‐containing blood components. TRALI has usually been associated with antibodies against granulocytes and HLA class I antigens, but more recently with antibodies against HLA class II and monocytes. TRALI cases were investigated to determine correlation between antigen and antibody. Additionally, activation of monocytes by TRALI serums was studied.

A randomized, controlled Phase III trial of therapeutic plasma exchange with fresh-frozen plasma (FFP) prepared with amotosalen and ultraviolet A light compared to untreated FFP in thrombotic thrombocytopenic purpura

BACKGROUND: Photochemical treatment of fresh‐frozen plasma (FFP) with amotosalen and ultraviolet (UV) A light (PCT FFP) results in inactivation of a broad spectrum of pathogens while retaining coagulation factor activity, antithrombotic proteins, and von Willebrand factor–cleaving protease (VWF‐CP) activity.

Pharmacokinetic study of FFP photochemically treated with amotosalen (S‐59) and UV light compared to FFP in healthy volunteers anticoagulated with warfarin

BACKGROUND : To date, no clinical trials have characterized FFP infusion efficacy, and infusion still carries infectious risk. This single‐blinded crossover study compared postinfusion kinetics of FVII in photochemically treated FFP to standard FFP.

Peripheral T-cell lymphoma: a clinicopathologic study of a morphologically diverse entity

We analyzed the clinicopathologic features of 13 patients with immunologically confirmed peripheral T‐cell lymphoma. The lymphomas were classified into poorly differentiated lymphocytic, mixed cell, and large cell types. Marked morphologic heterogeneity was noted within the mixed cell and large cell categories, and the various subtypes are described. Twelve of the 13 patients received multiagent chemotherapy. Only three of the nine patients with poorly differentiated or mixed cell lymphomas achieved a complete remission, and the median survival for this group was 11 months. In contrast, all three of the treated patients with large cell lymphomas achieved a complete remission, two of whom are alive without disease (14 and 29 months, respectively). Classification of peripheral T‐cell lymphomas into lymphocytic, mixed cell, and large cell types, as well as further subclassification within the heterogeneous groups, is suggested so that pathologic features of prognostic significance can be identified. Cancer 56: 2061‐2068, 1985.

A human plasma cell line. Induction and characterization

A stable line of IgG K producing human plasma cells was established from a myelomatous human bone marrow using conditioned media from a rapidly metabolizing lymphoblast line, RPMI 4098. Growth in RPMI 1640 (15% fetal calf serum) at 6% CO2 promoted a 62‐hour doubling time with a preferred cell concentration of 1 × 106/mL. Surface marker studies showed: no receptors for sheep erythrocytes, no surface immunoglobulins, variable number of cells bearing complement receptors and 83% bearing Fe receptors. Although transmission electron micrographs demonstrated a poorly developed endoplasmic reticulum, radioimmunoassay showed 23 ng IgG and 28.7 ng Kappa were produced by 1 × 106 cells in 72 hours. Further, the cells are lipase, esterase and Epstein‐Barr nuclear antigen negative. ASG banding showed a total chromosome number that varied from 46–49. Since the number of human plasma cell lines is limited, it is felt that this line will augment the immunobiological study of human myeloma.

Passive immunization of macaques against SIV infection

Passive immunization with plasma from an inactivated‐whole SIVmac vaccine protected monkey conferred complete or partial protection to rhesus macaques challenged intravenously 4 or 18 hours later with 10 AID50 of homologous cell‐free virus. In contrast, passive immunization with inactivated plasma or purified immunoglobulin (Ig) from SIVmac infected asymptomatic monkeys failed to protect any recipients similarly challenged and may have enhanced infection and accelerated disease. Administered 24 hours post challenge, anti‐SIV Ig may also have enhanced the infection.

A case of T-cell lymphoma with convoluted lymphocytes.

A case of T‐cell lymphoma, as defined by immunologic studies of lymph node, peripheral blood, and cultured cells, is presented. Convoluted lymphocytes were noted in the original lymph node biopsy, in cerebral spinal fluid preparations and, terminally, in the peripheral blood. The prominent neuologic abnormalities representing both central and peripheral nervous system involvement were atypical. Other features included skin and testicular infiltration, leukemic transformation, and refractoriness to therapy. A somewhat similar clinical picture has been reported in other patients with diffuse, poorly differentiated lymphocytic lymphomas, some of which have proven to have a T‐cell origin. T‐cell lymphoma may represent a distinct clinical entity that calls for modifications of our traditional therapeutic approaches.

Cytogenetic evidence that the malignant event in multiple myeloma occurs in a precursor lymphocyte.

Multiple myeloma is traditionally thought of as a disease of plasma cells. Evidence from studies using antiodiotype antibodies, however, suggests that malignant events may take place in a precursor lymphocyte perhaps as early as the pre-B cell. In this study, we present cytogenetic evidence to support the latter view. Peripheral blood was obtained from a patient with plasma cell leukemia and light chain disease. Karyotypic analysis, using Giemsa banding techniques, showed an abnormal karyotype: 44,XY,-6,-8,-13,-16,-22,+mar1,+ mar2,+mar3,del(1)(p22,p32),11p+,13q+,14q+. A suspension culture was established and a plasma cell line was grown. It was characterized by transmission electron microscopy as having an eccentric nucleus, abundant cytoplasm, and extensive endoplasmic reticulum. A subculture of this line was subsequently grown that was characterized by transmission electron microscopy as a lymphoid cell with diminished quantity of cytoplasm without extensive endoplasmic reticulum. Karyotypic analysis of the smaller cell demonstrated a modal number of 88 chromosomes and was a tetraploid derivative of the first. Our study provides cytogenetic evidence that cells with a lymphocytic phenotype show karyotypic abnormalities seen in the malignant plasma cell of the same patient, and thus, can be considered as evidence favoring the initiating cell of plasma cell myeloma as being an early B lymphocyte.

Concurrent development of preleukaemic, lymphoproliferative and plasma cell disorders

Summary. A patient is described who presented with a combined preleukaemic, lymphoproliferative and plasma cell disorder. These disorders were not related to cytotoxic therapy. The clonal nature of the lymphoid component was demonstrated by lymphocyte surface marker studies and the clonal nature of the plasma cell component by immunoperoxidase studies. Since the involved lymphoid and plasma cells contained different heavy and light chains, they were felt to originate from two separate B cell clones not related to the clone responsible for the preleukaemic component.