bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients' attitudes regarding out‐of‐hospital blood transfusion
Authors: Benson K. , Balducci L. , Milo K. M. , Heckel L. , Lyman G. H. 
Published: March 2003

BACKGROUND: While the administration of blood transfusions outside of the hospital has become more prevalent, little is known about patients' attitudes regarding this practice.STUDY DESIGN and METHODS: Twenty‐ nine adult patients who regularly received blood transfusions in a hospital's outpatient clinic and had never received home transfusions were surveyed. Linear analogue and categorical monetary scales were used to evaluate their responses to a series of questions.RESULTS: At the time of the survey, 27 study participants (93%) did not want home transfusions, and 21 (72%) thought home transfusions posed a greater risk than hospital based transfusion. More than half (56%) of the participants were unwilling to pay more for a home transfusion for themselves than for an outpatient hospital‐based transfusion. Participants were willing to pay more for a home blood transfusion for a hypothetical patient requesting transfusions at home. The lack of available transportation and poor patient health were identified as important factors in determining how much more they would be willing to pay for transfusions at home.CONCLUSION: While blood transfusions at home may become more accessible, many patients may prefer to receive their transfusions in the hospital, probably because home transfusions are thought to pose a greater risk. A patient's health and the availability of transportation were determined to be important factors in decisions about how much more money to spend for transfusions at home than for those in an outpatient hospital setting.
Risk factors for Trypanosoma cruzi infection in California blood donors
Authors: Galel S.A. , Kirchhoff L.V. 
Published: March 2003

Background: Trypanosoma cruzi, the protozoan parasite that causes Chagas'disease, is endemic in Central and South America and in Mexico. Risk of infection is related to exposure to insects harboring T. cruzi or to the transfusion of blood from an infected donor. Large numbers of immigrants from endemic areas reside in California, but the frequency with which persons at risk for T. cruzi contribute to the blood supply there is not known.Study Design and Methods: A questionnaire was used to survey donors in 18 California donor centers for risk factors for T. cruzi infection.Results: Otherwise eligible allogeneic blood donors (n = 17,521) completed questionnaires. Of this group, 427 (2.4%) had lived in endemic areas for more than 1 year, and 39 of these donors had lived in dwellings with mud walls or thatched roofs. Sixteen donors had received transfusions in endemic areas. Six donors gave a history of Chagas' disease. Fifty‐seven donors (0.33% of total) had at least one risk factor for T. cruzi infection. Donors at risk for T. cruzi were found in all 18 centers studied, at a median prevalence of 1 per 340 donors.Conclusion: Donors at risk for T. cruzi are contributing to the blood supply throughout California. Further consideration should be given to donor screening for this transfusion‐transmissible infection.
Hemolytic anemia in chronic large granular lymphocytic leukemia of natural killer cells: Cytotoxicity of natural killer cells against autologous red cells is associated with hemolysis
Authors: GILSANZ F. , de la SERNA J. , MOLTó L. , ALVAREZ‐MON M. 
Published: March 2003

BACKGROUND: It has ben suggested that natural killer cells are effectors in some hemolytic transfusion reactions, but a direct mechanism of the destruction of red cells has not been demonstrated.CASE REPORT: Lytic activity of natural killer cells against autologous red cells was found in a patient with large granular lymphocytic leukemia of natural killer cells and hemolytic anemia, with no evidence of immune antibody or complement‐mediated hemolysis. Large granular lymphocytes in the blood showed a CD2+ CD3‐ CD16+ CD57+ phenotype, cytotoxic activity against natural killer cell‐sensitive K562 target cells, and no lytic activity against natural killer cell‐resistant JY target cells. Cytotoxicity directed against red cells was quantified by a 51Cr‐specific release assay with autologous and ABO‐identical red cells used as target cells and the patients purified natural killer cells used as effector cells in the presence and absence of autologous serum. The cytotoxic activity of natural killer cells was directed against autologous red cells but not against allogenic red cells, and it was not enhanced by the presence of autologous serum in the medium. Clinical remission was induced by the administration of cyclophosphamide, after which no evidence of cytotoxic activity against the red cells could be found. CONCLUSION: Hemolytic anemia in the presence of a negative direct antiglobulin test can be attributed to a direct cytotoxic mechanism mediated by natural killer cells.
Microbiologic contamination of peripheral blood progenitor cells collected for hematopoietic cell transplantation
Authors: Espinosa M.T.F. , Fox R. , Creger R.J. , Lazarus H.M. 
Published: March 2003

Background: Peripheral blood progenitor cells (PBPCs) rather than bone marrow are used increasingly to provide hematologic reconstitution when transfused after marrow‐ablative chemotherapy. PBPCs often are collected via central venous catheters that have remained in place for long periods of time and that may become infected. Study Design and Methods: The investigators reviewed their 5‐year experience in collecting PBPCs for the prevalence of bacterial contamination. Except for cotrimoxazole therapy given to prevent Pneumocystis cariini pneumonia, patients were not given antibiotic prophylaxis. Results: Each patient underwent a median of 7 (range, 2–21) PBPC collections; 0.2 percent (3/1040 collections) were culture positive for bacteria (two collections contained coagulase‐negative staphylococci and one contained Serratia marcescens). All culture‐positive collections were discarded; no PBPCs were culture positive at the time of thawing and transfusion. Conclusion: This contamination rate is below that previously reported for bone marrow harvests and platelet concentrate collections. Obtaining PBPCs through large‐bore central venous catheters has not added to the risk of infection in transplant patients. A program of screening in vitro cultures and strict adherence to sterility techniques can result in very low microbiologic contamination and thus obviates the need for prophylactic antimicrobials in the PBPCs and in the patient.
Comparative performances of enzyme‐linked immunosorbent, western blot, and polymerase chain reaction assays for human T‐lymphotropic virus type II infection that is endemic among Indians of the Gran Chaco region of South America
Authors: Poiesz B.J. , Dube S. , Jones B. , Bryz‐Gornia V. , Dean M.T. , Spicer T. , Hengst J. , Sayre K. , Esteban E. , Ferrer J.F. 
Published: March 2003

BACKGROUND: Human T‐cell lymphoma/leukemia viruses types I and II (HTLV‐ I and HTLV‐II) are related exogenous human retroviruses. The former is definitely pathogenic while disease association with the latter is unclear. There are two subtypes of HTLV‐II, A and B. Currently, enzyme‐ linked immunosorbent assays (ELISAs) based on HTLV‐I antigens are used to screen for the presence of HTLV‐I and ‐II antibodies. Confirmation and subtyping are accomplished by Western blot (WB) or ELISAs based on HTLV‐I whole viral antigens and/or HTLV‐I and HTLV‐IIA peptides. The sensitivity and specificity of these serologic assays were compared to those of HTLV‐I and‐II‐specific polymerase chain reaction (PCR) assays in tests on samples from Indians from South America in whom the HTLV‐ IIB subtype is endemic.STUDY DESIGN AND METHODS: Sera from 246 Gran Chaco Indians were evaluated for HTLV antibodies with the use of four ELISAs (Retrotek HTLV‐I; Cambridge Biotech rgp21 enhanced HTLV‐I/II; Vironostika HTLV‐I/II; and Select HTLV‐I/II), and a WB assay. Peripheral blood leukocyte DNA from each Indian was analyzed for HTLV‐I or HTLV‐II pol DNA via PCR. Fifteen of the PCR‐positive samples were further subtyped via cloning and sequencing and/or oligomer restriction.RESULTS: Ninety‐seven samples (39%) were positive for HTLV‐ II by serologic and/or PCR assays. All 15 positive DNA samples that were further analyzed were of the HTLV‐IIB subtype and were clustered as a highly conserved phylogenetic group. Comparative analyses indicate that the sensitivity and specificity of the various assays were: PCR, 97 and 100 percent; Retrotek, 70 and 91 percent; Cambridge Biotech, 74 and 96 percent; Vironostika, 73 and 99 percent; Select 72 and 98 percent; and WB, 70 and 100 percent.CONCLUSION: The sensitivities of the tested HTLV serologic assays were comparable. However, the specificity of the Retrotek ELISA was significantly lower than that of the others. When positive, the subtyping assays were very specific. However, PCR assays would seem preferable or to be a necessary adjunct for the sensitive detection of HTLV‐IIB infection.
The use of polymerase chain reaction in plasma pools for the concomitant detection of hepatitis C virus and HIV type 1 RNA
Authors: Yerly S. , Pedrocchi M. , Perrin L. 
Published: March 2003

BACKGROUND: Detection of viral nucleic acids might increase blood transfusion safety through the detection of recently infected blood donors during the preseroconversion window period. Individual screening is difficult to apply, because of technical and financial constraints.STUDY DESIGN AND METHODS: A polymerase chain reaction (PCR)‐based assay including a polyethylene glycol precipitation step was developed for the concomitant detection of hepatitis C virus (HCV) and HIV type 1 (HIV‐1) RNA in plasma pools corresponding to 50 blood donations by the use of commercial assays.RESULTS: The assay had a sensitivity of less than 33 copies per mL for HCV RNA and 1000 copies per mL for HIV‐1 RNA for each individual sample included in the pool. The eight preseroconversion samples with HCV RNA between 1,250 and 762,000 copies per mL were all detected when 100‐μL aliquots from the samples were introduced into 5‐mL pools of 50 blood donations.CONCLUSIONS: A PCR‐ based pooling assay associating a prepurification step with polyethylene glycol allows for the screening of blood donations for HCV and HIV‐1 RNA without marked loss of sensitivity from that seen with commercially available assays. This procedure might increase blood safety through systematic screening of blood donations at relatively low cost.
Intra‐apheresis recruitment of blood progenitor cells in children
Authors: Abe T. , Makimoto A. , Kawano Y. , Okamoto Y. , Kajiume T. , Nakagawa R. , Watanabe H. , Sato J. , Watanabe T. , Kuroda Y. , Takaue Y. 
Published: March 2003

BACKGROUND: Determination of the optimal duration of apheresis requires a careful examination of blood progenitor cell (BPC) kinetics during apheresis. Intra‐apheresis recruitment of BPCs should be evaluated.STUDY DESIGN AND METHODS: Twenty‐six apheresis procedures were performed in 13 children with various malignant disorders (ages, 10 months to 17 years; median, 7 years) to collect BPCs for autologous transplant, using a blood cell separator with 2 to 5.2 blood volumes processed. The subjects were divided into three groups according to age: below 1 year (n = 4), 2 to 10 years (n = 5), and 11 to 20 years (n = 4). BPCs were mobilized by a combination of chemotherapy and granulocyte‐colony‐stimulating factor (G‐CSF; 2–7.5 micrograms/kg/day intravenous drip). The levels of circulating CD34+ cells and colony‐ forming units‐granulocyte‐macrophage (CFU‐GM) were monitored to examine intra‐apheresis recruitment. For every 50 mL per kg or 2 L of processed blood, 5‐mL blood samples were collected via a central line.RESULTS: In the first apheresis procedure, more CD34+ cells were mobilized by the procedure itself in the infant group than in the older groups, and the number of cells decreased with the subject's age. When the same analysis was made during the second apheresis procedure, performed 1 day later, the levels of both CD34+ cells and CFU‐GM had decreased to below the preapheresis values in all of the populations. Cell yields in the second apheresis procedure were significantly lower than those in the first.CONCLUSION: Although several factors prevent a reliable analysis, the data suggest that the intra‐apheresis recruitment of BPCs may be age‐specific; the continuous and prolonged supply of cells from the bone marrow to peripheral blood that occurs during apheresis is more predominant in infants, which leads to the collection of proportionately more BPCs in younger children than in their older counterparts.
The effects of dilution on the outcome of pooled plasma testing with HIV type 1 (HIV‐ 1) RNA genome amplification as compared to the outcome of individual‐unit testing with other HIV‐1 markers
Authors: Kemper M. , Witt D. , Madsen T. , Kuramoto K. , Holland P. 
Published: March 2003

BACKGROUND: Proposed testing of large plasma pools with genome amplification technology (GAT) for detection of transfusion‐ transmissible viruses may have unanticipated complications not associated with individual unit testing. One such potential complication, the effect of dilution resulting from pool formation, was the subject of the present study.STUDY DESIGN AND METHODS: Specimens from three plasma donor HIV type 1 (HIV‐1) seroconversion panels were tested with a quantitative HIV‐1 RNA GAT assay (lower detection limit, 400 copies). GAT results were compared to HIV‐1 p24 antigen and anti‐ HIV‐1/2 enzyme immunoassay results. Effects of dilution on the detection of GAT‐positive panel specimens were assessed by terminal dilution with pooled volunteer‐donor EDTA plasma samples.RESULTS: Low HIV‐1 RNA copy numbers (755 and 890 copies/0.1‐mL input) that were detectable in two individual plasma specimens before HIV‐1 p24 antigen were subsequently undetectable by GAT upon dilution with an equal volume of nonreactive plasma from a single donor. HIV‐1 RNA at higher copy numbers (15,500 copies/0.1‐mL input) in an HIV‐1 p24 antigen‐ reactive and anti‐HIV‐1/2‐nonreactive specimen was undetectable when diluted to 1‐in‐50 (1‐in‐50). Terminal dilution of seven HIV‐1 RNA‐ containing plasma panel specimens indicated a proportional loss of HIV‐ 1 RNA detectability with increasing dilution.CONCLUSION: GAT for detection of HIV‐1 RNA in individual specimens was more sensitive than other HIV markers. For pooled plasma testing, GAT‐independent constraints, such as effects of dilution, may preclude the use of GAT detection as a replacement for individual unit testing with HIV serologic assays.
White cell subsets in apheresis and filtered platelet concentrates
Authors: Sowemimo‐Coker S.O. , Kim A. , Tribble E. , Brandwein H.J. , Wenz B. 
Published: March 2003

BACKGROUND:White cell (WBC)‐reduced platelet concentrates (PCs) are defined by their absolute WBC count, a criterion which provides no information regarding the various WBC subsets contained in the PC. These heterogeneous cells are known to mediate different physiologic and pathophysiologic functions and account for distinct adverse transfusion responses. This study describes a method which allows the detection and quantification of these subsets and characterizes their presence in a variety of platelet components.STUDY DESIGN AND METHODS:Random‐donor pooled PCs (RD PCs) and single‐donor apheresis PCs (SD PCs) were studied. RD PCs consisting of 6 units of 2‐ to 3‐day old PCs were randomly assigned to be filtered with one of four WBC‐reduction filters from three different manufacturers (n=34). The residual WBCs were pelleted by centrifugation and isolated on a density gradient. The various WBC subsets were quantified by flow cytometry in unfiltered and filtered PCs using fluorescence and two‐angle light scatter. SD PCs obtained with two manufacturer's systems and three processing protocols (n=30) were studied in like manner.RESULTS:WBC counts for non‐WBC‐ reduced PCs averaged 3 × 10(8) in RD PCs and ranged from 8.6 to 9.6 × 10(6) per SD PC. Residual WBC counts in filtered PCs ranged from 2.3 × 10(4) to 2.2 × 10(5) and those in WBC‐reduced SD PCs averaged 2.2 × 10(5) per unit. The data demonstrate significant phenotypic differences among PCs produced with various procedures. All SD PCs and two of four filtered RD PCs contained five WBC populations including granulocytes and monocytes, while RD PCs filtered with the remaining manufacturer's devices contained only lymphocytes. CONCLUSION: The data confirm that distinct phenotypic differences exist among PCs prepared with different devices and/or procedures. It is suggested that as for non‐generic pharmaceuticals, the clinical benefits of these various PCs should be individually proved.
A Gly565→Als substitution in human erythroid band 3 accounts for the Wu blood group polymorphism
Authors: Zelinski T. , McManus K. , Punter F. , Moulds M. , Coghlan G. 
Published: March 2003

BACKGROUND: Reports published in 1976 and 1980 described the low‐ incidence red cell antigen Wu. Distinction of Wu from all other known low‐incidence antigens and from the ABO, Rh, Lutheran, Duffy, Kidd, P, and X‐linked blood group systems allowed Wu to be placed in the International Society of Blood Transfusion's 700 series, designated as 700013. Recently, a blood donor apparently homozygous for Wu has been identified. This report documents the serologic and molecular findings of samples from this individual and the members of his family.STUDY DESIGN AND METHODS:Blood samples from 26 members of a kindred of Dutch descent segregating for Wu were collected and analyzed. Red cells were subjected to titration and enzymatic tests, while DNA was analyzed by polyacrylamide gel electrophoresis for single‐strand conformational polymorphism (SSCP) and nucleotide differences by DNA sequencing.RESULTS:Serologic investigations conducted on red cells of the propositus and two of his siblings consistently revealed higher titers with various sera containing anti‐Wu than did cells from their parents or children. Treatment of intact red cells with alpha‐chymotrypsin completely abolished Wu recognition. Because erythroid band 3 is cleaved by alpha‐chymotrypsin, the possible relationship between Wu and AE1 (the gene controlling erythroid band 3 expression) was investigated by molecular methods. SSCP analysis of DNA revealed that all Wu+ family members exhibited a mobility shift in exon 14 of AE1. The nature of the SSCP was defined by DNA sequencing as a G–>C mutation that resulted in a Gly565–>Ala substitution in human erythroid band 3.CONCLUSIONS:Three members of the kindred are homozygous for the low‐incidence red cell antigen Wu. A G–>C mutation in AE1 gives rise to a Gly565–>Ala substitution in band 3, thereby accounting for the Wu red cell polymorphism. In light of these findings, the International Society of Blood Transfusion Working Party has provisionally assigned Wu to the Diego blood group system (designated 010009 or D19).
Blood component recalls in the United States
Authors: Ramsey G. , Sherman L. A. 
Published: March 2003

BACKGROUND: United States blood suppliers are required to recall marketed blood components later found to be in violation of Food and Drug Administration (FDA) regulations for safety, purity, and potency. Many recalled units have already been transfused. Analysis of the frequency and nature of blood component recalls would be useful for blood suppliers, transfusion services, and physicians.STUDY DESIGN AND METHODS: Each blood component recall in the weekly FDA Enforcement Report from 1990 through 1997 was examined for the number of units, recall reason, and hazard class. Units for manufacturing were excluded.RESULTS: In 8 years, an estimated 241,800 blood components were recalled, or approximately 1 in 700 units available to US hospitals. Eighty‐eight percent of recalled units were in 22 large recalls of over 1000 units each. The most common reasons were incorrect testing for syphilis (57% of units) or viral markers (19%), reactive or previously reactive donor viral markers (6‐11%), and inadequate donor‐history screening (4%). Twelve units were in the FDA's highest hazard Class I, 24 percent were in Class II, and 76 percent were in Class III. Over 43,900 units had HIV‐related problems, but only 3 units involved HIV transmission. Large recalls have declined since peaking in 1995, but units in small recalls increased 116 percent in 1997 over the previous 7‐year average.CONCLUSIONS: Although high‐risk recalls are rare, many blood component recalls pose medical concerns for physicians and patients. The recent decline in large recalls may be due to increased FDA oversight, stricter accreditation standards for quality improvement, and more centralized donor testing in large specialized laboratories. However, smaller recalls, which involve nearly all blood suppliers, were sharply higher in 1997.
The timing of granulocyte–colony‐stimulating factor administration after chemotherapy does not affect stem and progenitor cell apheresis yield: a retrospective study of 65 cases
Authors: Lefrère F. , Audat F. , Hermine O. , Cavazzana‐Calvo M. , Belanger C. , Arnulf B. , Buzyn A. , Varet B. 
Published: March 2003

BACKGROUND: The optimal time for postchemotherapy granulocyte–colony stimulating factor (G–CSF) administration before peripheral blood stem and progenitor cell (PBPC) collection is not well defined. The impact of G–CSF scheduling on the number of CD34+ cells collected by leukapheresis from 65 patients with malignant disease was studied retrospectively.STUDY DESIGN AND METHODS: Chemotherapy was performed on Days 1 and 2 and was followed by G–CSF to mobilize PBPCs. In Group 1, 30 patients received the first dose of G–CSF immediately after the end of chemotherapy, as commonly recommended. In Group 2, 35 patients received the first G–CSF dose after the end of chemotherapy (Days 7 or 8).RESULTS: No difference was observed between the two groups in white cell recovery and the median number of CD34+ cells harvested. The number of leukapheresis procedures necessary to obtain the minimal number of 3 × 106 CD34+ cells per kg was the same. The proportion of patients with a failure of PBPC collection was similar, and G–CSF consumption was reduced in Group 2 without increasing infectious risks.CONCLUSION: Early administration of G–CSF after chemotherapy appears not to be a prerequisite for satisfactory PBPC collection. This approach could allow significant savings in terms of medical cost. A randomized and prospective study would be necessary, however, to assess the validity of these conclusions.