bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regeneration of erythropoiesis after related‐ and unrelated‐donor BMT or peripheral blood HPC transplantation: a major ABO mismatch means problems
Authors: Worel N. , Greinix H.T. , Schneider B. , Kurz M. , Rabitsch W. , Knöbl P. , Reiter E. , Derfler K. , Fischer G. , Hinterberger W. , Höcker P. , Kalhs P. 
Published: March 2003

BACKGROUND: Blood group incompatibility in allogeneic BMT is common but does not appear to affect the outcome in terms of incidence of graft rejection or delayed engraftment. However, major ABO incompatibility may be associated with prolonged erythroid aplasia.STUDY DESIGN AND METHODS: In a retrospective analysis of 286 allogeneic transplant recipients, the prevalence of prolonged erythroid aplasia, including pure RBC aplasia, was determined.RESULTS: Patients receiving major ABO‐incompatible grafts showed a significant delay in reticulocyte engraftment (median, 32 days; range, 12‐347) from that in patients receiving ABO‐identical (20; 10‐152) or minor ABO‐incompatible (21; 12‐47) grafts. Pure RBC aplasia occurred in 7 (3%) of 240 evaluable recipients and was observed only in the major ABO‐incompatible group (7/43, 16%). Treatment of pure RBC aplasia consisted of either plasma exchange, which resulted in a response within 16 to 68 days, or immunoadsorption, in which the response occurred between Days 119 and 204 after initiation of treatment.CONCLUSION: Major ABO incompatibility may lead to delayed reticulocyte engraftment, resulting in prolonged transfusion dependency and increased risks of transmission of infection and iron overload. Therefore, therapeutic strategies should be taken into consideration to allow erythroid reconstitution in these patients.
Alloimmunization in preterm infants after repeated transfusions of WBC‐reduced RBCs from the same donor
Authors: Strauss Ronald G. , Johnson Karen , Cress Gretchen , Cordle Delores G. 
Published: March 2003

BACKGROUND: Preterm infants are among the most heavily transfused of patient groups, yet multiply transfused infants only rarely produce alloantibodies against RBC or WBC antigens. It is not known whether rates of alloimmunization might be increased by repeated exposure to RBCs and WBCs from the same donor, as in limited‐donor‐exposure programs, or whether infants might benefit from WBC‐reduced RBC components as a means of diminishing the risk of possible alloimmunization.STUDY DESIGN AND METHODS: Preterm infants (birth weight 0.6‐1.3 kg) received prestorage WBC‐reduced RBCs from dedicated donors, collected in AS‐3 as a means of limiting donor exposures. Blood samples were collected serially from infants shortly after birth until either discharge or age 6 months and were studied for RBC and WBC antibodies—the latter with reactivity against either HLA class I or neutrophil‐specific antigens.RESULTS: Thirty preterm infants received 139 transfusions (mean, 4.6; median, 4 transfusions per infant), with 81 percent of transfusions obtained from one donor per infant. Eighty‐four blood samples (mean, 2.7/infant) were studied, and no infant produced RBC antibodies. Twenty‐seven percent of infants exhibited WBC antibodies, but only 13 percent actually produced WBC antibodies (passive maternal antibody excluded). Of the WBC antibodies produced by infants, three were against HLA class I and one was against neutrophil‐specific antigens; none were linked to adverse effects.CONCLUSIONS: Because infants only rarely produce RBC antibodies, no changes in blood banking practices are necessary for limited‐donor‐exposure programs. Although the production of WBC antibodies by infants occurs, it seems to be uncommon; thus, the possible benefits, if any, of WBC reduction are uncertain, and further study is required before changes in practice can be justified.
A new h allele detected in Europe has a missense mutationin α(1,2)‐fucosyltransferase motif II
Authors: Wagner Thomas , Vadon Maria , Staudacher Erika , Schmarda Andreas , Gassner Christoph , Helmberg Wolfgang , Lanzer Gerhard , Flegel Willy A. , Wagner Franz F. 
Published: March 2003

BACKGROUND: The FUT1 gene encodes an α(1,2)‐fucosyltransferase (H transferase), which determines the blood group H. Nonfunctional alleles of this gene, called h alleles and carrying loss‐of‐function mutations, are observed in the exceedingly rare Bombay phenotype. Twenty‐three distinct h alleles have been characterized at the molecular level in various populations. The FUT2 (SE) gene is highly homologous to FUT1 (H).STUDY DESIGN AND METHODS: The FUT1 gene of an Austrian proband with the Bombay phenotype was characterized by nucleotide sequencing of the full‐length coding sequence. A PCR method using sequence‐specific primers for FUT2 genotyping in whites was developed. The plasma α(1,2)‐fucosyltransferase activity was determined. The distribution of the mutations underlying 24 h alleles and 7 se alleles was analyzed.RESULTS: The proband carried a new h allele. Two nucleotide changes, G785A and C786A, in codon 262 of the FUT1 gene resulted in the replacement of serine by lysine. No α(1,2)‐fucosyltransferase activity was detected in the proband's plasma. The proband was homozygous for the seG428A allele. Six of 17 missense mutations in nonfunctional h and se alleles occurred in highly conserved fucosyltransferase motifs. No loss‐of‐function mutation was observed in the aminoterminal section encompassing the transmembraneous helix.CONCLUSION: The missense mutation S262K in the FUT1 gene caused the loss of H transferase activity. The analysis of the distribution of mutations in nonfunctional FUT1 and FUT2 genes can point to functionally important domains in the H transferase.
Long‐term survival in transfusion recipients in Sweden, 1993
Authors: Tynell Elsa , Norda Rut , Shanwell Agneta , Björkman Anders 
Published: March 2003

BACKGROUND: Survival and characteristics of transfusion recipients have not been studied enough, although they represent key measures in cost‐effectiveness analyses of various donor screening procedures.STUDY DESIGN AND METHODS: Hospital and blood bank records were collected on all patients in Örebro County, Sweden, from March through May 1993 (1111 transfusion episodes) and a random sample from Stockholm County during April 1993 (793 transfusion episodes). All patients were then matched with the national register of deaths in Sweden during a follow‐up period of 40 months.RESULTS: The median patient age was 71 years and the median transfusion total was 2 units. Only 35 percent of the patients were under the age of 65, 9 percent under 40, and 1.6 percent under 1 year. About half (56%) were women. Among the Örebro patients, 47 percent were surgical and 29 percent internal medicine patients. Of 1720 patients whose survival could be investigated, 66 percent were alive after 1 year and 51 percent after 40 months. The survival rates were rather similar in patients receiving RBCs and plasma but lower in those receiving platelets.CONCLUSION: The survival of patients transfused in Sweden in 1993 differered significantly from estimations based on studies from the 1980s. This difference has major implications for the estimations of cost‐effectiveness of blood donor screening for infectious agents.
Human platelets express gangliosides with LKEactivity and ABH blood group activity
Authors: Cooling Laura L.W. , Zhang DeSheng , Koerner Theodore A.W. 
Published: March 2003

BACKGROUND: Platelets express several neutral glycosphingolipids with ABH and P blood group activity that may play a role in infectious, autoimmune, and alloimmune thrombocytopenia. In RBCs, sialylated glycosphingolipids or gangliosides with blood group activity have also been reported. To determine whether similar antigens are expressed by platelets, the total platelet ganglioside fraction was isolated and screened for blood‐group‐active glycosphingolipids.STUDY DESIGN AND METHODS: Platelet gangliosides were isolated by organic extraction, base hydrolysis, anion exchange, silicic acid, and high‐performance liquid chromatography. Gangliosides were identified and characterized by high‐performance thin‐layer chromatography‐immunostaining with blood group‐specific MoAbs and glycosidase digestion.RESULTS: Group A, but not group O, platelets express five gangliosides with group A activity. Of five A MoAbs and lectins examined, only MoAbs Birma‐1 and MHO4 recognized all five sialyl A bands. The sialyl A bands were sensitive to endoglycoceramidase and neuraminidase. One sialyl A band may represent a branched ganglioside with sialyl‐I and group A activity. Platelets also express an LKE‐active ganglioside consistent with sialyl‐galactosylgloboside.CONCLUSION: In addition to sialyl‐iI and sialyl‐Lex gangliosides, group A platelets express gangliosides with LKE activity and group A activity. Like RBCs, group A‐active gangliosides may act as alloantigens and autoantigens to naturally occurring isohemagglutinins.
Analysis of the kinetics of TPOuptake during platelet transfusion
Authors: Folman Claudia C. , De Jong Shreyas M. , De Haas Masja , Von dem Borne Albert E.G.Kr. 
Published: March 2003

BACKGROUND: It has been shown in several studies that platelets play a role in the removal of TPO from the circulation. For instance, in vitro studies have shown that platelets can bind and internalize TPO, and transfusion studies have shown that the concentration of circulating TPO decreased after platelet transfusion. In the current study, the in vivo kinetics of plasma TPO levels and TPO uptake by transfused platelets is analyzed in more detail.STUDY DESIGN AND METHODS: Serial blood samples from patients who received a platelet transfusion were analyzed with respect to platelet count, plasma TPO concentration, and TPO content per platelet. In addition, the capacity of transfused platelets to bind TPO in vitro was assessed.RESULTS: Platelet counts increased immediately after transfusion, but subsequently started to decrease. Conversely, TPO levels decreased significantly but then returned to baseline level by 44 hours after transfusion. Platelet count and plasma TPO concentration were inversely correlated (rp = −0.9; p<0.05). The decrease in TPO concentration upon transfusion was accompanied by a significant increase in the platelet‐associated TPO concentration. After transfusion, platelets isolated from the patient still displayed functional TPO receptors, as indicated by their intact capacity to bind TPO in vitro.CONCLUSION: The decrease in plasma TPO followed by the increase in platelet TPO provides evidence that platelets are responsible for the clearance of TPO in circulation. In vivo, platelets can bind and may degrade TPO upon platelet transfusion.
In vitro and in vivo measurementsof gamma‐radiated, frozen, glycerolized RBCs
Authors: Valeri C. Robert , Pivacek Linda E. , Cassidy George P. , Ragno Gina 
Published: March 2003

BACKGROUND : Transfusion‐associated GVHD results from the presence of viable lymphocytes in transfused allogeneic blood components. Viable immunocompetent lymphocytes have been detected in RBCs that were frozen with glycerol and washed before transfusion.STUDY DESIGN AND METHODS : The study reported here assessed the effect of irradiation on human RBCs frozen with 40‐percent (wt/vol) glycerol and stored at –80°C. In vitro and in vivo testing was done on human RBCs that were frozen with 40‐percent (wt/vol) glycerol at –80°C, with some units exposed to 2500 cGy of gamma radiation and others not irradiated, and that, after thawing and washing, were stored in a sodium chloride‐glucose solution at 4°C for 3 days before autologous transfusion.RESULTS : The glycerol‐frozen RBCs treated with 2500 cGy before deglycerolization had a mean freeze‐thaw‐wash recovery of 87 percent and a mean 24‐hour posttransfusion survival of 86 percent after storage for 3 days at 4°C in a 0.9‐percent NaCl and 0.2‐percent glucose solution. For the nonirradiated units, the mean freeze‐thaw‐wash recovery was 85 percent and the mean 24‐hour posttransfusion survival was 83 percent.CONCLUSION : These data show similar, acceptable results for RBCs frozen with 40‐percent (wt/vol) glycerol at –80°C and treated in the frozen state with 2500 cGy of gamma radiation and for RBCs that were not irradiated, all of which were washed and then stored in a sodium chloride‐glucose solution for 3 days before autologous transfusion.
The effect of external pressure, catheter gauge, andstorage time on hemolysis in RBC transfusion
Authors: Frelich Regina , Ellis Martin H. 
Published: March 2003

BACKGROUND: RBC transfusions are often administered using externally applied pneumatic pressure. The effect of this practice on RBC hemolysis was studied during simulated transfusion performed in the laboratory.MATERIALS AND METHODS: RBC transfusions were performed sequentially via 16‐, 18‐, 20‐, and 22‐gauge cannulas with the application of a pneumatic pressure device at pressures of 150 and 300 mmHg. Hb concentration, Hct, RBC count, free Hb, potassium, and LDH concentrations were measured in 5 mL of transfusate.RESULTS: Forty‐seven RBC units, 20 fresh units (mean age, 10.8 days) and 27 old units (mean age, 28.9 days) were studied under all conditions. Multiple regression analysis revealed that the age of the unit and the external pressure applied were significant determinants of the degree of hemolysis.CONCLUSIONS: The application of an external pressure device results in minimal destruction of transfused RBCs, even under the most stringent conditions examined. Thus, external pressure application to expedite an RBC transfusion is likely to be a safe procedure for the majority of patients. Unusual clinical situations, such as massive transfusion in pediatric patients, should be specifically examined to confirm the safety of this procedure.
The effect of the interruption of agitation on plateletquality during storage for transfusion
Authors: Hunter Suzanne , Nixon Janice , Murphy Scott 
Published: March 2003

BACKGROUND: A considerable amount of data and the CFR suggest that platelet concentrates (PCs) should be stored with continuous, gentle agitation before transfusion. However, there are only limited data concerning the mechanisms of platelet damage that may occur when agitation is interrupted, and there are no CFR guidelines concerning shipment between periods of storage.STUDY DESIGN AND METHODS: PCs were prepared by the platelet‐rich plasma method and stored for 5 days at 20 to 24°C; agitation was interrupted for 1 to 3 days either by simply stopping the agitator or by placing the PCs in a stationary shipping container. Measurements of platelet metabolism and quality were made during storage and on Day 5.RESULTS: With interruption on the agitator, the production of lactic acid was increased during the interruption in proportion to the number of platelets in the PC and the duration of the interruption. The pO2 was increased during agitation interruption, which suggested a decline in oxygen utilization. With the use of the hypotonic shock response and the extent of shape change as reflections of platelet quality, there was no evidence of platelet damage unless the pH fell to or below 6.5. No PC reached this level after an interruption of agitation for only 1 day, irrespective of which day was chosen for interruption. PCs whose agitation was interrupted for 2 and 3 days were at risk of having a pH less than 6.5 if their contents were greater than 1.25 × 1011 and 0.75 × 1011 platelets, respectively. Interruption of agitation for 1 day in the shipping container produced results essentially identical to those produced by interruption on the agitator.CONCLUSION: Interruption of agitation of PCs for 1 day, either on the agitator or in the shipping container, produces no platelet damage measurable by these in vitro techniques. However, an interruption of agitation for 2 days can result in significant damage in some components. Further studies will be required to learn more about the mechanisms that lead to the metabolic changes described and to determine if the same generalizations apply to apheresis PCs and PCs prepared from pooled buffy coats.
Ceftizoxime‐induced hemolysis secondary to combined drug adsorption and immune‐complex mechanisms
Authors: Calhoun Beverly W. , Junsanto Tipsuda , Donoghue Maria De Tolve , Naureckas Edward , Baron Joseph M. , Baron Beverly W. 
Published: March 2003

BACKGROUND: Immune hemolytic anemia has been associated with the administration of various antibiotics, including cephalosporins. Presented here is a patient who developed severe acute hemolysis while receiving ceftizoxime (Ceftizox, Fujisawa USA), a third‐generation cephalosporin. This is the fourth reported case of hemolysis in association with ceftizoxime. In the previous cases, ceftizoxime was shown to induce hemolysis by the immune‐complex mechanism. However, in one of those reports, the concentration of drug used to treat the target RBCs in vitro may not have been optimal.CASE REPORT: The patient's antemortem blood samples were analyzed retrospectively for drug‐dependent antibodies by the drug‐adsorption and immune‐complex methods. Antibody class and titer were evaluated.RESULTS: The patient's sample agglutinated RBCs coated with ceftizoxime as well as uncoated RBCs in the presence of ceftizoxime. The antibodies to ceftizoxime were IgM and IgG.CONCLUSION: This is the first report on both the immune‐complex and drug‐adsorption mechanisms of ceftizoxime‐induced hemolysis. The differential diagnosis of a falling Hct in a patient receiving antibiotics should include drug‐related hemolysis; once this diagnosis is considered, management includes the appropriate serologic workup, immediate cessation of the implicated drugs, and possible transfusion support.
Knowledge of HIV/AIDS transmission and screening in United States blood donors
Authors: Sharma Usha K. , Schreiber George B. , Glynn Simone A. , Nass Catharie C. , Higgins Martha J. , Tu Yongling , Bethel Jim , Williams Alan E. ,   for the Retrovirus Epidemiology Donor Study
Published: March 2003

BACKGROUND : Increased knowledge of HIV transmission and behavioral and test screening may encourage high‐risk blood donors to self‐defer.STUDY DESIGN AND METHODS: Knowledge of HIV transmission and screening and the association with demographics, screening test reactivity, and unreported deferrable risks (UDRs) was assessed by a 1998 anonymous mail survey sent to 92,581 blood donors, of whom 57 percent responded. Groups were compared by using weighted chi‐square tests and logistic regression analysis.RESULTS: Four percent of the donors thought that it was very likely or somewhat likely for a person to contract HIV from donating blood, and 20 percent perceived a similar risk from blood transfusion. Only 60 percent of the donors knew that the available screening tests may not detect a recent infection. Thirty‐seven percent either did not know or felt it was acceptable to donate blood to obtain HIV testing. Those most likely to answer knowledge questions incorrectly were more likely to have a higher prevalence of test reactivity or UDRs and to be <25 years old, members of a minority, less educated, non‐US‐born, or first‐time donors.CONCLUSION : Innovative ways to increase donor understanding of the implications of risk behaviors and the limitations of current screening procedures should be developed. They might prevent high‐risk individuals from donating blood.
Assessment of rapid remobilization intervals with G–CSF and SCF in murine and rhesus macaque models
Authors: Shi Patricia A. , Pomper Gregory J. , Metzger Mark E. , Donahue Robert E. , Leitman Susan F. , Dunbar Cynthia E. 
Published: March 2003

BACKGROUND: Defining the optimum regimen and time for repeat peripheral blood progenitor cell mobilization would have important clinical applications.STUDY DESIGN AND METHODS: Remobilization with SCF and G–CSF at 2 weeks after an initial mobilization in mice and at 2 or 4 weeks after an initial mobilization in nonhuman primates was examined. In mice, competitive repopulation assays were used to measure long‐term progenitor cell‐repopulating activity. In monkeys, mobilization of hematopoietic progenitor CFUs was used as a surrogate marker for progenitor cell‐repopulating ability.RESULTS: Efficacy of progenitor cell remobilization differed in the two animal species. In mice, peripheral blood progenitor cell‐repopulating ability with repeat mobilization at 2 weeks was 70 percent of that with the initial mobilization. In monkeys, there was no significant difference in peripheral blood progenitor cell mobilization between the initial and the repeat mobilizations at 2 weeks. In mobilizations separated by 4 weeks, however, peripheral blood progenitor cell mobilization was higher than that with initial mobilizations.CONCLUSION: In animal models, mobilization of peripheral blood progenitor cells with remobilization after a 2‐week interval is similar to or moderately decreased from that with the initial mobilization. Progenitor cell collection at this time point may be useful in certain clinical circumstances. A 4‐week interval between remobilizations may be preferable. Clinical trials in humans would be useful to clarify these issues.
Increased RBC autoantibody production in pregnancy
Authors: Hoppe Berthold , Stibbe Werner , Bielefeld Annette , Pruss Axel , Salama Abdulgabar 
Published: March 2003

BACKGROUND: Autoimmunization against RBCs is generally believed to occur very rarely during pregnancy and to represent a high risk for those affected. The occurrence of benign RBC autoantibodies in pregnancy is reported.STUDY DESIGN AND METHODS: The incidence of autoantibodies to RBCs in unselected pregnant and nonpregnant women were compared by the new standard gel hemagglutination method.RESULTS: Data from a total of 22,782 pregnant and 12,903 nonpregnant women were analyzed. The antibody screen test was positive in 547 (2.40%) of the pregnant women. The positive test results were related to passive anti‐D in 341 cases (1.50%), to clinically relevant alloantibodies in 43 cases (0.19%), to clinically irrelevant antibodies in 138 cases (0.61%), to autoantibodies in 23 cases (0.1%), and to autoantibodies plus alloantibodies in 2 cases (0.01%). In the cases of alloantibodies and/or autoantibodies, the DAT was invariably positive with anti‐C3d and less commonly so with anti‐IgG. The autoantibodies were first detected during pregnancy, they predominantly reacted with enzyme‐treated RBCs, and none of the affected women or their infants appear to have developed clinically significant hemolysis. In the control group consisting of nonpregnant female blood donors, there were 3 cases (0.02%) of clinically insignificant IgG autoantibodies.CONCLUSION: There is an increase in autoimmunization against RBCs during pregnancy. The resultant autoantibodies do not appear to cause significant RBC destruction. Further studies are required for precise characterization of this phenomenon.