bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concurrent comparison of the cobe spectra and fenwal CS3000 for the collection of peripheral blood mononuclear cells for autologous peripheral stem cell transplantation
Authors: Padley Doug , Strauss Ronald G. , Wieland Martha , Randels M. Joleen 
Published: February 2007

AbstractHematopoietic stem cells, collected by leukapheresis from peripheral blood, can be used as an alternative to autologous bone marrow transplantation following high‐dose chemotherapy as treatment of several malignancies. We compared the ability of the Cobe Spectra and the Fenwal CS3000 to collect peripheral blood mononuclear cells (MNC) for autologous peripheral blood stem cell transplantation. Ten patients experienced repeated leukapheresis (10 L blood processed per procedure) using both instruments. Procedures were alternated between the two until a total of 7 × 108 MNC/kg was collected. Data from 61 Spectra and 50 CS3000 collections were analyzed. The yield (mean per procedure) of nucleated cells (NC) and MNC was higher (P < .005) with the Spectra (0.77 × 1010 NC and 0.54 × 1010 MNC) than with the CS3000 (0.59 × 1010 NC and 0.40 × 1010 MNC). However, colony forming units (CFU‐GM) were not different (P > .05) for Spectra (0.92 × 104) and Fenwal (0.65 × 104) collections. Platelet contamination was lower (P < .001) with the Spectra (2.2 × 1011) than the CS3000 (5.0 × 1011). This correlated with a higher patient blood platelet count immediately following Spectra collections (117 × 109/L) versus the CS3000 (86 × 109/L). Using the methods described, the Spectra product contained greater yields of NC and MNC with less platelet contamination than did the CS3000.
Plateletpheresis with the new fresenius AS 104 blood cell separator
Authors: Valbonesi M. , Frisoni R. , Fella M. , Capra C. , Malfanti L. , Ferrari M. , Zia S. , Florio G. , Nickel H. 
Published: February 2007

AbstractAmong the many blood cell separators introduced into the international market in these last few years, the Fresenius AS 104 represents an advanced and safe thrombocytapheresis machine whose development took advantage of extensive worldwide experience with blood cell separation. Nonetheless the AS 104 has generated most interest in West Germany and most, if not all, the studies published on its platelet collection efficiency have been carried out in that country. It is normally reported that from 2.7 to 3.5 × 1011 platelets can be collected in approximately 80 minutes. Since these results could not be duplicated routinely in our hemapheresis unit, we set up a study by modifying the standard procedure. It was possible to reduce the procedure time and to collect platelet concentrates containing more than 4 × 1011 cells on a routine basis by using the following procedure: ACD‐A/blood ratio 1:10; Interface position 6:2; blood flow rate always exceeding 65 mL/min; rpm 1750; cell collection from 4 to 7 mL/min; volume of blood processed 3.6 L followed by the rinsing of the system with 200 ml of saline; extraction of the content of the secondary separation chamber by the action of the plasma pump working at 20 mL/min for 2 min. With this procedure the platelet yield in 34 collections exceeded 3.1 × 1011 and averaged 4.06 × 1011. The procedure time was reduced to 56.5 minutes with a mean blood flow rate of 62.3 mL/min. The leukocyte and erythrocyte contamination of the products were in the range of 1 × 107 and 1 × 108 respectively. By the methods of counting employed, leukocyte contamination was too low to be determined in 25 preparations. Only two minor citrate reactions were recorded.
Current status of hemapheresis in the United States
Authors: Strauss Ronald G. 
Published: February 2007

AbstractThe face of automated hemapheresis in the United States is changing. No longer is it appropriate to view hemapheresis primarily in terms of therapeutic plasma exchange. For many centers, the bulk of day‐to‐day activities revolves around donor cytapheresis to satisfy the ever‐increasing need for units of platelet concentrates. Indications of therapeutic plasma exchange are becoming better focused, with neurological patients being among those most frequently managed. New and innovative applications of automated hemapheresis technology will continue to be developed. Current examples include the production of lymphocyte‐activated leukocytes for cancer therapy, use of extracorporeal photoactivation of leukocytes for immune modulation, and the collection of hematopoietic progenitors from peripheral blood for autologous transplantation. As we enter the 1990s, it is important to be aware of new technology and applications and to have the vision to apply them in innovative ways. However, it is also critical to demand rigorous scientific review before broadly adopting any new idea as a standard of practice.
Peripheral blood mononuclear cell collection from patients undergoing adoptive immunotherapy or peripheral blood‐derived stem cell transplantation and from healthy donors
Authors: Keilholz Ulrich , Klein Harvey G. , Körbling Martin , Brado Bernadett , Carter Charles S. , Cullis Herb , Galm Frank , Hunstein Werner 
Published: February 2007

AbstractThe demand for collection of mononuclear cells from the peripheral blood of patients for therapeutic purposes is rapidly increasing. Automated blood cell separators are usually designed for collection of blood components from healthy donors. We reviewed safety and efficiency of collection data of a new procedure for the Fenwal CS 3000 blood cell separator in 125 collections from normal donors and 101 collections from patients after IL‐2 pretreatment or chemotherapy. The new procedure set red blood cell spillovers to occur at 3.5 minute intervals, using procedure 1 with the interface detector set at 1,000 and the standard granulocyte and collection chambers.Despite significant anemia and thrombocytopenia in a large number of patients no serious procedure‐related side effects occurred. The lymphocyte yield was 4.74 ± 1.6 × 109 per 5 liters of blood processed in normal donors and 24.2 ± 12.0 × 109 per 10 liters of blood processed after IL‐2 treatment. After chemotherapy the lymphocyte yield was 4.5 ± 3.1 × 109 per 10 liters of blood processed; the collection efficiency was found to be significantly lower in this group. The main problem was the platelet loss of 35.6 ± 12% of the initial count in normal donors, 40.3 ± 14.1% after IL‐2 treatment, and 42.1 ± 18.0% after chemotherapy. The platelet loss is, however, closely related to the preapheresis platelet count; patients with thrombocytopenia lose fewer platelets than normal donors. Therefore the procedure was found to be safe for patients with a platelet count as low as 20/nl.
Cyclosporin‐induced hypertriglyceridemia with prompt response to plasma exchange therapy
Authors: Valbonesi M. , Occhini D. , Frisoni R. , Malfanti L. , Capra C. , Gualandi F. 
Published: February 2007

AbstractA case of severe cyclosporin‐induced hypertriglyceridemia that prompted plasma exchange therapy is reported. Hyperlipemic retinitis, headache, stupor, and peripheral paresthesias became apparent when the level of triglycerides exceeded the 1,500 mg/dL level. Two plasma exchanges were required to halt disease progression. This is the second time that plasma exchange was used in a bone marrow transplanted patient on cyclosporin‐A therapy. In both cases hypertriglyceridemia became apparent and symptomatic after approximately 7 months of therapy with cyclosporin.
Management of sickle cell anemia and pregnancy
Authors: Koshy Mabel , Chisum Darren , Burd Laurence , Orlina Armando , How Helen 
Published: February 2007

AbstractThere has been significant decrease in maternal morbidity and mortality of sickle cell disease patients during pregnancy due to better understanding of the pathophysiology of the disease and physiologic changes during pregnancy.Prophylactic blood transfusion does not appear to reduce complications in patients with sickle cell anemia. Patients with sickle hemoglobin C disease and with Sβ thalassemia+ have fewer complications but still need close monitoring.Blood transfusion therapy should be made available for medical and obstetrical complications to include increasing hypoxemia, progressive anemia, acut chest syndrome, twin pregnancy, splenic sequestration syndrome, preeclampsia, septicemia, or prior to general anesthesia and surgery. Blood transfusion therapy is associated with hepatitis, allergic reaction, alloimmunization, AIDS, and iron overload states. These aspects should be considered prior to using blood transfusion therapy.Excellent prenatal monitoring and aggressive intervention should be instituted when problems arise for the successful management of the pregnant patient with sickle cell disease. Prenatal diagnosis and cord blood screening should be made available for the infant. Appropriate pediatric referral and prophylactic penicillin is recommended for the infant with sickle cell disease.
Ten years experience with therapeutic apheresis in a community hospital
Authors: Kornfeld Peter , Fox Sondra , Maier Karen , Mahjoub Mazen 
Published: February 2007

AbstractA retrospective study was carried out on 2,500 therapeutic hemapheresis procedures performed at a community teaching hospital from 1980 to 1990. Seventy‐six percent of the procedures consisted of plasmapheresis (PE). The most frequently treated conditions were myasthenia gravis (MG), Guillain‐Barré syndrome (GB), hyperviscosity (HV), and thrombotic thrombocytopenia purpura (TTP). Therapeutic results and clinical implications for these four conditions are discussed. © 1992 Wiley‐Liss, Inc.
An unexpected complication following immunoadsorption with a staphylococcal protein a column
Authors: Huestis Douglas W. , Rifkin Robert M. , Durie Brian G. M. , Sibley William A. , Irani Mehraboon 
Published: February 2007

AbstractExtracorporeal immune adsorption with staphylococcal protein A (SPA) columns can remove immune complexes and immunoglobulins in the treatment of a variety of diseases. We present the case of an elderly man with neuropathy associated with monoclonal gammopathy, treated by 3 on‐line SPA procedures. At the completion of these treatments his neuropathy relapsed, progressing to near‐total paralysis. Return to a baseline clinical status required several months. The reason for this severe relapse is not clear. Possible explanations include SPA activation of T‐lymphocytes, with release of gamma interferon and increased antigen recognition, or removal of an anti‐idiotype control mechanism. We advise caution in the application of immunoadsorption to conditions in which it has not yet been evaluated. © 1992 Wiley‐Liss, Inc.
Backwashing procedure for on‐line reuse of a plasma fractionator in cryofiltration
Authors: Sawada Koji , Ohshima Tadashi , Zborowski Maciej , Malchesky Paul S. , Koo Anna P. , Skibinski Christine I. 
Published: February 2007

AbstractDuring membrane plasma fractionation therapy there are reported incidences of membrane plugging requiring the corrective actions of either filter replacement or backwashing (BW) in order to continue the treatment. In this preliminary study, a simple BW procedure to allow for on‐line reuse of the filter (Asahi AP06M) during the treatment was evaluated to assess its efficacy and safety in cryofiltration (CF).Evaluations were carried out on two patients treated for rheumatoid arthritis. Seven tests, each using 1 L or 2 L warmed saline as a BW solution were performed to evaluate the decrease of the transmembrane pressure (TMP) between just before and after backwashing and TMP change during cryofiltration procedures between before and after backwashing. Sieving coefficients of total protein, albumin, immunoglobulins (G, M, A), fibrinogen, and rheumatoid factor were also calculated at 1,000 ml plasma volume processed.Results showed statistically significant decreases of TMP from 300 mm Hg to 70 mm Hg between just before and after both backwashing procedures, and that there were no significant changes in the TMP increase during the cryofiltration procedure between pre‐ and post‐BW. The protein sievings were not significantly affected by BW. The use of a second liter for rinsing did not reduce the inlet pressure further suggesting that 1 L BW was adequate. The accumulated solutes did not affect significantly the effective mean pore size. The BW procedure did not affect the overall patient safety during therapy.In conclusion, this simple BW procedure using 1 L of normal saline and accomplished in approximately 11 minutes by a manual procedure proved reliable to rinse the filter and to prolong its clinical use. This procedure obviated the need for filter replacement.
Specificity of antibody responses affected by extracorporeal immunoadsorption of plasma over columns of protein A silica
Authors: Snyder Harry W. , Seawell Betty W. , Cochran Sharon K. , Balint Joseph P. , Jones Frank R. 
Published: February 2007

AbstractA relationship is described between the interaction of circulating immune complexes (CIC) from plasma with staphylococcal protein A immunoadsorption treatment columns and modulation of antibody responses related to the specific CIC. Eluates from the initial immunoadsorption columns used to treat a series of patients with breast adenocarcinoma, cancer chemotherapy‐associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (C‐TTP/HUS), or immune thrombocytopenic purpura (ITP) were evaluated for disease‐specific CIC containing Lex glycosphingolipid (Lex gl) adenocarcinoma‐associated antigens or platelet autoantibody (anti‐GPIIb/IIIa), together with the corresponding neutralizing antibody [anti‐F(ab′)2], and for nonspecific CIC containing cytomegalovirus (CMV) or herpes simplex virus type 1 (HSV‐1) antigens. In addition, the levels of antibodies directed against CMV, HSV‐1. Lex gl, and GPIIb/IIIa antigens, as well as anti‐F(ab′)2 antibodies, were compared in pretreatment and posttreatment serum samples.Columns used to treat breast adenocarcinoma patients contained only Lex gl CIC, and the only immunologic change observed after treatment was significant increases in anti‐Lex gl antibodies in some patients. Columns used to treat C‐TTP/HUS patients contained anti‐GPIIb/IIIa‐anti‐F(ab′)2 CIC, in addition to Lex gl CIC. After treatment, significant increases in anti‐Lex gl and anti‐F(ab′)2 antibodies and significant decreases in anti‐GPIIb/IIIa antibodies were observed in some patients. Columns used to treat ITP patients only exhibited anti‐GPIIb/IIIa‐anti‐F(ab′)2 CIC, and after treatment only decreases in anti‐GPIIb/IIIa and increases in anti‐F(ab′)2 antibodies were observed in some patients. None of the treatment columns exhibited CIC with CMV or HSV‐1 antigens, and no effects on pretreatment levels of anti‐CMV or anti‐HSV‐1 antibodies were observed in any patients posttreatment. Immunologic responses were correlated closely with clinical responses in each group of patients. The study showed that neither stimulation nor depression of antibody responses occurred in the absence of an interaction of corresponding specific CIC with the matrix. The results suggest that nonspecific stimulation of a variety of antibody responses is not the usual mechanism by which clinical responses to protein A immunoadsorption treatment are obtained. © 1992 Wiley‐Liss, Inc.
Analysis of venous access for therapeutic plasma exchange in patients with neurological disease
Authors: Grishaber J. E. , Cunningham M. C. , Rohret P. A. , Strauss R. G. 
Published: February 2007

AbstractWe retrospectively analyzed our 2‐year experience with venous access for 363 therapeutic plasma exchanges in 46 patients with neurological disease, including acute Guillain‐Barré syndrome (N = 20), myasthenia gravis (N = 17), and chronic inflammatory demyelinating polyneuropathy (N = 9). Twenty‐three patients (50%) completed the planned course of therapy using only peripheral venous access, and 28 central venous catheters were placed in the remaining 23 patients. Patients utilizing central venous access did not undergo a greater number of procedures, but they were more likely to have acute Guillain‐Barré syndrome (P < 0.02) or to be hospitalized in a medical intensive care unit (P < 0.01). Three types of central catheters were used, and although our experience was predominantly with 1 type, differences were noted. Only 3% of procedures (3 of 96) done with a Quinton‐Mahurkar catheter were associated with a catheter failure, compared to 27% (4 of 15, P < 0.01) with a Hickman catheter and 67% (2 of 3) with a triple‐lumen catheter. Life‐threatening complications occurred with 3 of 28 (11%) central catheters. To optimize the success of therapeutic plasma exchange using central access, it is critical that hemapheresis personnel advise each patient's primary physician regarding the type of central venous catheter required. Currently, we recommend use of a Quinton‐Mahurkar or other dual‐lumen hemodialysis catheter. © 1992 Wiley‐Liss, Inc.
Role of plasmapheresis in acute disseminated (postinfectious) encephalomyelitis
Authors: Stricker Raphael B. , Miller Robert G. , Kiprov Dobri D. 
Published: February 2007

AbstractAcute disseminated encephalomyelitis (ADEM) is a demyelinating central nervous system disease that is associated with high morbidity and mortality. Although the recognition of ADEM may be facilitated by newer imaging techniques, the optimal treatment of this disease remains uncertain. We describe 4 patients with severe ADEM who responded to treatment that included intensive plasmapheresis. Two of the patients were in coma at the time that plasmapheresis was instituted, and all 4 patients made an excellent recovery. Immunologic studies revealed increased serum IgA levels, increased circulating immune complex levels as measured by the Raji cell assay, and decreased numbers of T and B cells prior to treatment of ADEM. These abnormalities improved following plasma exchange. Plasmapheresis appears to be effective in reversing the neuropathologic process in ADEM. The role of this treatment modality in ADEM requires further evaluation in controlled clinical trials. © 1992 Wiley‐Liss, Inc.
Subacute (acute, persistent) thrombotic microangiopathy
Authors: Taft Edwin G. , Carver Bala B. 
Published: February 2007

AbstractSix patients with prolonged acute courses of thrombotic microangiopathy are reviewed. These patients had in common courses of acute disease requiring plasma support for more than 3 months, with subsequent complete remission. Plasma support requirements may be prodigious, and the acute course may require more than 100 plasma exchanges before a stable remission is achieved. These patients appear to represent a subset of thrombotic microangiopathy distinct from the more common acute T.T.P. course, which resolves in 3–6 weeks, and the chronic relapsing pattern, which may have a short or prolonged acute course. © 1992 Wiley‐Liss, Inc.
Therapeutic cytoreduction in a 7‐month‐old baby with acute leukemia
Authors: Huestis Douglas W. , Hutter John J. , James Peggy 
Published: February 2007

AbstractA 7‐month‐old girl with acute biphenotypic leukemia [t(4;11)] had accompanying anemia, thrombocytopenia, and a white blood cell count of 535,000/μL with 98% blasts. Before instituting chemotherapy, therapeutic leukapheresis was done to reduce the threat of complications from leukostasis. Using a Cobe Spectra blood cell separator primed with modified blood, we processed 1,395 mL of her blood, removing 201 mL of the buffy coat containing 5.8 × 1010 white blood cells. This reduced the WBC count to 301,000/μL. Only a single procedure was done, without significant complications. The rationale of this preparatory cytoreduction is discussed critically. Subsequent chemotherapy resulted in a long‐lasting remission. © 1992 Wiley‐Liss, Inc.
Peripheral blood stem cell transplantation: Impact on procedure load and workload in an apheresis unit
Authors: Ghalie Richard , McLeod Bruce , Richman Carol , Valentino Leonard , Manson Sharon , Netols Carol , Kaizer Herbert 
Published: February 2007

AbstractPeripheral blood stem cells (PBSC) reinfusion appears to hasten hematologic reconstitution following myeloablative therapy. While procurement of PBSC adds apheresis procedures, rapid engraftment could decrease the demand for platelet transfusions. To determine the impact of PBSC collection on workload in our apheresis unit, we studied 3 consecutive groups of patients with metastatic breast cancer given comparable high‐dose chemotherapy and autologous bone marrow transplant, with or without PBSC or granulocyte‐colony stimulating factor (G‐CSF). Forty‐one transplants were performed with bone marrow cells only: 31 patients (Group A) did not receive G‐CSF, while the following 10 patients (group B) received daily G‐CSF until neutrophil engraftment. Bone marrow cells and PBSC were used for the most recent 11 transplants (group C), followed by daily G‐CSF until engraftment. PBSC were mobilized with cyclophosphamide (4 g/m2) and etoposide (1 g/m2), followed by G‐CSF, 8 μg/kg/day. PBSC collection was carried out on a Fenwal CS3000 + cell collector, using modified procedure 1, to obtain a minimum of 5 × 108 mononuclear cells/kg. The times to neutrophil count over 500/μL, platelet count over 20,000/μL, and discharge from the hospital after transplant were significantly shorter for patients in group C (medians of 8, 8, and 21 days, respectively) compared to group A (medians of 14, 14, and 29 days; P = 0.001) or group B (medians of 11, 24, and 32 days; P < 0.001). The number of single‐donor platelet equivalents transfused (1 SDE = 1 unit of single‐donor platelets or 8 pooled random‐donor platelets) was significantly decreased in group C (median = 4) compared to group A (median = 19) and group B (median = 11; P = 0.001 for both comparisons). The total apheresis procedure load (the sum of SDE and PBSC collection for each transplant) was significantly decreased in group C (median = 6) compared to groups A and B combined (median = 14; P = 0.001). The apheresis unit workload assessing apheresis durations per patient, calculated as 2 × SDE + 4 × PBSC, was also significantly reduced in group C (median = 16) compared to groups A and B (median = 28; P = 0.002). Thus, PBSC were advantageous in terms of faster engraftment, reduced platelet transfusions, and shorter hospitalization, while decreasing both procedure load and net workload per patient in the apheresis unit. © 1992 Wiley‐Liss, Inc.