bluuebunny/crossref_metadata_2025_split huggingface dataset:
RBC alloantibody specificity and antigen potency in Olmsted County, Minnesota
Authors: Winters Jeffrey L. , Pineda Alvaro A. , Gorden Lemuel D. , Bryant Sandra C. , Melton L. Joseph , Vamvakas Eleftherios C. , Moore S. Breanndan 
Published: March 2003

BACKGROUND: While RBC antigen frequencies for whites of Northern European ancestry are known, the relative frequencies of RBC antibodies within this population have not been determined. The distribution of RBC alloantibodies by sex and age was studied, as were the immunogenicity of RBC antigens and the occurrence of RBC alloantibody clusters in a geographically defined population.STUDY DESIGN AND METHODS: RBC alloimmunization among patients and donors in Olmsted County, MN, was determined for the period from 1975 to 1995. Alloantibody frequencies were used to calculate the potency of each antigen relative to K. Cluster analysis was applied to the data to identify natural groupings of antibodies.RESULTS: The frequency and potency of 33 alloantibodies from 1345 alloimmunized subjects were estimated. The most frequent alloantibodies were E (20.8%), Lea (18.6%), K (14.7%), D (12.9%), Leb (9.4%), M (7.2%), P1 (6.7%), Fya (6.3%), C (6.8%), and c (3.5%). The most potent antigens were Wra (0.363), Cw (0.078), Lea (0.03), E (0.028), V (0.025), Jsa (0.023), Kpb (0.023), Goa (0.023), JMH (0.023), and Rd (0.023). Greater frequency of overall alloimmunization (M:F = 1:2.7), anti‐D (p<0.0001), and anti‐Lea (p = 0.003) was seen among females. Warm autoantibodies were more frequent among males with positive antibody screens (p<0.0001). No other gender differences were observed. Alloimmunization increased with age for K, Kpa, Fya, D, C, E, and warm autoantibodies. Frequencies of alloimmunization to Lea, Leb, M, and P1 decreased with age. The cluster analysis showed grouping of the antibodies to C and D as well as to Lea and Leb, but the other RBC alloantibodies did not form clusters.CONCLUSION: Less than 1 percent of residents tested had positive antibody screens. Anti‐E and anti‐Lea were more common than anti‐K. Wra and Cw were more potent antigens than K. Most antibodies showed an increase in frequency with increasing age. Except for anti‐C and ‐D and anti‐Lea and ‐Leb, RBC alloantibodies did not occur in clusters.
Evaluation of a reporting system for bacterial contamination of blood components in the United States
Authors: Roth Virginia R. , Kuehnert Matthew J. , Haley N. Rebecca , Gregory Kay R. , Schreiber George B. , Arduino Matthew J. , Holt Stacey C. , Carson Loretta A. , Elder Kathleen V. , Jarvis William R. 
Published: March 2003

BACKGROUND:The transfusion of blood components contaminated with bacteria may have serious clinical consequences, but few data are available on the incidence of these events. A national effort to assess the frequency of blood component bacterial contamination associated with transfusion reaction (the BaCon Study) was initiated to better estimate their occurrence.STUDY DESIGN AND METHODS:Standard reporting criteria, data collection forms, and a standardized reporting protocol were developed in collaboration with the American Red Cross, AABB, and the Department of Defense. Episodes reported to the BaCon Study were compared with those reported to the FDA's national reporting systems to estimate the extent to which all serious reactions associated with bacterial contamination were captured.RESULTS:During the first 2 years, 38 episodes meeting study criteria were reported; 21 were laboratory‐confirmed. The estimated proportion of episodes reported to the BaCon Study (i.e., completeness of coverage) was lower than that reported to the FDA during the same period (0.33 vs. 0.68), but the positive predictive value was higher (0.66 vs.0.28).CONCLUSION:Despite the complexity of obtaining reports from a large number of United States hospitals and transfusion centers, the feasibility and usefulness of the BaCon Study were shown. This study was the only national study in the United States to monitor adverse clinical events associated with bacterial contamination of blood components. By building on hospital‐based reporting of transfusion‐related adverse events, the BaCon Study serves as a model for the study of other complications associated with blood and blood components.
C‐reactive protein and IL‐6: new marker proteins for the diagnosis of CJD in plasma?
Authors: Völkel Dirk , Zimmermann Klaus , Zerr Inga , Lindner Thomas , Bodemer Monica , Poser Sigrid , Schwarz Hans Peter 
Published: March 2003

BACKGROUND: CJD is usually diagnosed by clinical and neuropathological findings. A number of proteins regarded as markers for neuronal damage in plasma or serum have recently been described. Markers typical for tissue damage, although not usually associated with CJD, are another possibility. An evaluation of the relative usefulness of markers of neuronal and tissue damage in identifying CJD could be beneficial.STUDY DESIGN AND METHODS: Plasma samples were collected from 46 patients with sporadic CJD and from a control group of 42 healthy subjects. The samples were analyzed with tests that were specific for C‐reactive protein (CRP), IL‐6, neuron‐specific enolase (NSE), S‐100 proteins, and cellular prion protein (PrPc). The results were compared, and a cutoff level for each test used was defined as the 90th percentile from the control group.RESULTS: The assay specific for NSE identified only 13 percent of the sporadic CJD patients as positive. The identification rate of the other markers was significantly higher: S‐100, 76.1 percent; PrPc, 76.1 percent; CRP, 78.3 percent; and IL‐6, 73.3 percent. Only three of the samples were positive in all five tests.CONCLUSION: The markers for tissue damage, CRP and IL‐6, are as useful as the previously described markers for neuronal damage in the diagnosis of CJD in plasma. All the markers tested are, however, of only limited value in the diagnosis of CJD in plasma. A combination of all surrogate markers improves the specificity but still provides no definitive diagnosis of the disease.
Kinetics of fetal cellular and cell‐free DNA in the maternal circulation during and after pregnancy: implications for noninvasive prenatal diagnosis
Authors: Ariga Hiromichi , Ohto Hitoshi , Busch Michael P. , Imamura Shinya , Watson Robert , Reed William , Lee Tzong‐Hae 
Published: March 2003

BACKGROUND: Fetal genetic material is detectable in the maternal circulation and has been used for noninvasive prenatal diagnosis. However, few data are available concerning its quantity and natural history during gestation.STUDY DESIGN AND METHODS: This study prospectively characterized the kinetics of cellular and cell‐free fetal DNA in the circulation of 25 healthy women during and after uncomplicated pregnancy. Real‐time kinetic PCR was used to quantitate human Y‐chromosome sequences, and liquid oligomer hybridization with 32P‐labeled probes was used to verify the identity of amplified products.RESULTS: In all male pregnancies, but no female pregnancies, low‐level fetal Y‐chromosome DNA was detected in both cellular and cell‐free compartments beginning at 7 to 16 weeks but increasing steadily after 24 weeks and reaching a peak at parturition. The fetal DNA decreased rapidly after birth.CONCLUSION: Fetal genetic material can be detected throughout pregnancy, and its quantity is a function of gestational age and of whether the plasma or cellular compartment is examined. Both the absolute quantity of fetal DNA and its ratio to total DNA (maternal + fetal) are greater in the plasma than in the cellular compartment. Fetal DNA is cleared rapidly from both compartments after parturition, which suggests that turnover is dynamic. Because they provide prospective and quantitative data concerning fetal DNA levels, these observations and kinetic PCR methods may have implications for noninvasive prenatal diagnosis. Further studies will be needed to determine the immunologic implications of fetal‐maternal DNA exchange and cellular microchimerism.
ABO mismatch may affect engraftment in multiple myeloma patients receiving nonmyeloablative conditioning
Authors: Badros Ashraf , Tricot Guido , Toor Amir , Morris Christopher , Guo Chuanfa , Munshi Nikhil , Barlogie Bart , Cottler‐Fox Michele 
Published: March 2003

BACKGROUND: Blood group incompatibility does not appear to affect the overall outcome in patients undergoing myeloablative conditioning before allogeneic BMT. Data on ABO‐mismatched transplantation in the nonmyeloablative setting are limited. STUDY DESIGN AND METHODS: A retrospective analysis of the effects of ABO mismatches in multiple myeloma patients who received a nonmyeloablative conditioning regimen was conducted. RESULTS: Three of 27 patients received a minor ABO‐mismatched graft, all with evidence of hemolysis before converting to donor ABO group on Days 10, 15, and 6. Six patients received a major ABO‐mismatched graft; of these, three developed GVHD of more than grade 2 and subsequently converted to the ABO blood group of the donor on Days 38, 33, and 43. Of the three patients without GVHD, one rejected the allograft and had autologous reconstitution. One remained a mixed chimera to Day 100 despite three donor lymphocyte infusions, and one developed pure RBC aplasia. None of the ABO‐matched patients rejected the graft, whether they developed GVHD or not. RBC transfusions were significantly higher in the major and minor ABO‐mismatched patients than in the ABO‐matched patients, with medians of 12 units (range, 2‐35), 13 units (range, 5‐18), and 4 units (range, 2‐15), respectively (p = 0.02). ABO‐matched patients had a similar incidence of GVHD, with 5 of 9 ABO‐mismatched patients (56%) having more than grade 2 versus 10 of 18 (56%). Four of 9 ABO‐mismatched patients (44%) were mixed chimeras up to Day 100 versus 2 of 18 ABO‐matched patients (11%), and the difference was significant (p = 0.01). CONCLUSION: Patients with ABO mismatch had problems with engraftment, including graft rejection, pure RBC aplasia, and mixed‐lineage chimerism. RBC transfusions were significantly higher in the ABO‐mismatched recipients. GVHD may play a role in engraftment, possibly by facilitating the disappearance of native ABO antibodies via graft‐versus‐plasma cell effect. A prospective study to evaluate the effects of ABO mismatch on engraftment in the nonmyeloablative setting is needed.
Kinetics of G–CSF‐induced granulocyte mobilization in healthy subjects: effects of route of administration and addition of dexamethasone
Authors: Stroncek David F. , Matthews Cynthia L. , Follmann Dean , Leitman Susan F. 
Published: March 2003

BACKGROUND: Granulocyte donors are frequently given G–CSF with or without dexamethasone approximately 18 hours before apheresis to increase cell yields. The purpose of this study was to assess the kinetics of G–CSF plus dexamethasone neutrophil mobilization to determine whether the neutrophils can be mobilized and collected the same day. STUDY DESIGN AND METHODS: Sixteen subjects were given four separate mobilization regimens: IV G–CSF (5 μg/kg), subcutaneous G–CSF (5 μg/kg), IV G–CSF (5 μg/kg) plus oral dexamethasone (8 mg), and subcutaneous G–CSF (5 μg/kg) plus oral dexamethasone (8 mg). Blood cell counts were measured before and after G–CSF administration. RESULTS: Following all four mobilization regimens, neutrophil counts fell 0.5 hour after the mobilizing agents were given, rose above baseline levels at Hour 2, and increased further with each time interval to Hour 8. In the absence of dexamethasone at Hours 2 through 8, there was no difference in neutrophil counts by subcutaneous or IV G–CSF administration routes. The addition of dexamethasone enhanced mobilization of neutrophils from Hours 3 through 24. Through Hour 8, there was no difference in the degree of mobilization among the subcutaneous G–CSF plus dexamethasone and the IV G–CSF plus dexamethasone regimens. However, at Hour 24, neutrophil counts were sustained at higher levels with subcutaneous G–CSF plus dexamethasone than with IV G–CSF plus dexamethasone. CONCLUSIONS: Granulocyte mobilization response to subcutaneous G–CSF plus dexamethasone is sustained at peak levels for 8 to 24 hours after coadministration of the two drugs. There was no advantage to giving G–CSF intravenously.
Acute nosocomial HCV infection detected by NAT of a regular blood donor
Authors: Larke Bryce , Hu Yu‐Wen , Krajden Mel , Scalia Vito , Byrne Sean K. , Boychuk Lesia R. , Klein Judith 
Published: March 2003

BACKGROUND : Routine HCV NAT of blood donors to detect persons in the preseroconversion phase of acute infection was introduced in Canada in October 1999. The source of virus exposure was investigated in the first, and to date only, blood donor found to be HCV NAT positive, anti‐HCV negative in Canada. He was a regular donor with none of the commonly reported risk factors for HCV infection. STUDY DESIGN AND METHODS : Epidemiologic follow‐up revealed that the blood donor had received antibiotics at an outpatient IV clinic 5 weeks before donation. IV solution bags and tubing for individual patients were stored in the clinic, and then the same equipment was used each time the patient returned for the next dose of antibiotics until it was replaced after every 72‐hour period. Among eight other patients whose clinic visitation times overlapped was a man with chronic HCV infection. Genomic sequencing of HCV isolates from the blood donor, the patient with chronic hepatitis C, and local controls was carried out to study possible nosocomial infection. RESULTS : Genomic sequencing showed a high degree of relatedness in the hypervariable region of HCV isolates from the blood donor and putative source patient as compared with controls. Detailed molecular analysis of quasispecies of the HCV isolates further indicated that viruses from the two individuals were genetically very close to each other. CONCLUSION : The introduction of routine screening of blood donors by HCV NAT was directly responsible for the early detection and investigation of an unusual case of HCV infection involving a regular donor. Genomic sequencing studies provided firm evidence of patient‐to‐patient transmission of HCV in an IV clinic. The report clearly demonstrates the value of molecular fingerprinting in tracking nosocomial HCV infections.
Predicting the effect of transfusing only phenotype‐matched RBCs to patients with sickle cell disease: theoretical and practical implications
Authors: Castro Oswaldo , Sandler S. Gerald , Houston‐Yu Patricia , Rana Sohail 
Published: March 2003

BACKGROUND : Transfusing only phenotype‐matched RBCs has been recommended to reduce the incidence of alloimmunization to blood group antigens in patients with sickle cell disease (SCD). STUDY DESIGN AND METHODS : The expected benefit of phenotype matching was determined by identifying which of the existing blood group alloantibodies in patients with SCD who received conventional transfusions would not have been formed if they had received only phenotype‐matched RBCs. By use of each patient's alloantibodies as a baseline, it was possible to identify specific alloantibodies that would not have been formed if each of five different phenotype‐matching protocols had been used. RESULTS
: During a 12‐year period, 351 patients received transfusions with 8939 units of ABO‐ and D‐matched RBCs. Of these, 102 patients (29.1%) formed at least one blood group alloantibody. An additional 35 patients with SCD with alloantibodies were identified by reviewing clinical records, yielding a total of 137 alloimmunized patients for inclusion in this study. If all transfusions had been selected by limited phenotype matching (C, c, E, e, and K, as well as for ABO and D), all alloantibodies would have been prevented for more than half (53.3%) of the 137 alloimmunized patients. If all transfusions had been matched for C, c, E, e, K, S, Fy
a
, and Jk
b , all antibodies would have been prevented for 70.8 percent of the 137 alloimmunized patients. Approximately 13.6 percent of random white blood donors would be expected to match a limited phenotype‐matching protocol, whereas only 0.6 percent would match an extended phenotype‐matching protocol. CONCLUSION : Limited phenotype matching would have prevented all alloantibodies in 53.3 percent of the patients who formed alloantibodies. This protocol requires RBCs that are readily available. Extended phenotype matching would have prevented alloimmunization in 70.8 percent of patients who formed alloantibodies. However, this would require phenotypes that are 22.7 times less prevalent among random blood donors and is therefore impractical for a long‐term strategy.
Prolonged in vitro hemolysis of EDTA‐anticoagulated blood after a delayed hemolytic transfusion reaction
Authors: Xenocostas Anargyros , Callum J.L. , Coovadia A.S. , Reis M.D. 
Published: March 2003

BACKGROUND : A novel case where in vitro hemolysis was observed in plasma, but not in serum samples, obtained after the onset of a severe delayed hemolytic transfusion reaction is presented. CASE REPORT : A 54‐year‐old woman received 2 units of blood during an orthopedic procedure. She had received transfusion 30 years earlier, and testing before transfusion revealed no alloantibodies. The patient returned 12 days after the transfusion with a Hb level of 54 g per L due to a severe delayed hemolytic reaction caused by anti‐K. The plasma and serum samples were grossly hemolysed on Day 12. On Day 14, the serum samples showed no evidence of hemolysis; however, the EDTA sample remained grossly hemolysed. This discrepancy was not identified until Day 19. Due to concerns of ongoing apparent severe hemolysis, the patient was unnecessarily treated with IVIG and corticosteroids. The in vitro hemolysis was still present at 75 days, despite complete normalization of her Hb, bilirubin, and LDH levels. The phenomenon had resolved by 125 days. CONCLUSION : This in vitro artifact has not been previously reported and the mechanism remains unclear. Both plasma and serum samples should be observed for hemolysis when evaluating a patient with a severe delayed hemolytic transfusion reaction.
Severe immune hemolysis after minor ABO‐mismatched allogeneic peripheral blood progenitor cell transplantation occurs more frequently after nonmyeloablative than myeloablative conditioning
Authors: Worel Nina , Greinix Hildegard T. , Keil Felix , Mitterbauer Margit , Lechner Klaus , Fischer Gottfried , Mayr Wolfgang , Höcker Paul , Kalhs Peter 
Published: March 2003

BACKGROUND : Hemolysis as a result of donor‐recipient minor ABO mismatching is a complication of allogeneic peripheral blood progenitor cell (PBPC) transplantation (PBPCT). The increased B‐lymphocyte content of PBPC grafts and immunosuppressive regimens without methotrexate (MTX) may increase incidence and severity of this event. STUDY DESIGN AND METHODS : A total of 93 patients were analyzed after allogeneic PBPCT. In 25 (27%) cases, minor (n = 21) or bidirectional (n = 4) ABO mismatching was present. Of these, 15 patients received myeloablative and 10 received nonmyeloablative conditioning regimens. For GVHD, prophylaxis cyclosporin A (CsA) alone (n = 2) or CsA with MTX (n = 13) was given after myeloablative conditioning and CsA with mycophenolate mofetil (MMF) after nonmyeloablative conditioning (n = 10). RESULTS : Hemolysis occurred in 4 out of 25 (16%) patients with minor or bidirectional ABO mismatching only. Three patients underwent nonmyeloablative conditioning and were given CsA with MMF, and one patient underwent myeloablative conditioning and was given CsA alone for GVHD prophylaxis. Hemolysis began 7 to 10 days after transplantation, and donor type alloantibodies were detectable concomitantly with recipients type RBCs. CONCLUSION : Patients receiving minor or bidirectional ABO‐mismatched PBPC grafts and GVHD prophylaxis without MTX are at risk of hemolysis. Prophylactic interventions in patients before minor ABO‐mismatched PBPCT not receiving MTX should be taken into con‐ sideration. Careful monitoring of hemolysis parameters during the first 15 days after PBPCT transplantation is mandatory.
Granulocyte transfusion therapy for infections in candidates and recipients of HPC transplantation: a comparative analysis of feasibility and outcome for community donors versus related donors
Authors: Hübel Kai , Carter Rachel A. , Liles W. Conrad , Dale David C. , Price Thomas H. , Bowden Raleigh A. , Rowley Scott D. , Chauncey Thomas R. , Bensinger William I. , Boeckh Michael 
Published: March 2003

BACKGROUND: Feasibility, response to granulocyte transfusion therapy, and clinical outcome were compared among HPC transplant recipients enrolled in a prospective study of a community blood bank‐based unrelated donors program, a prospective granulocyte study using family donors, and matched control patients without granulocyte transfusion therapy. STUDY DESIGN AND METHODS: Overall, 40 patients (327 collections) received granulocyte concentrates from unrelated donors, 34 patients (219 collections) received granulocyte concentrates from related donors, and 74 patients served as controls. Study entry criteria for patients included an absolute neutrophil count (ANC) of less than 200 per μL and documented invasive fungal or bacterial infections. RESULTS: There was a median delay of 3 days (range, 0‐14) in patients receiving transfusions from unrelated donors between day of diagnosis of infection and start of granulocyte transfusion therapy as compared with a median delay of 5 days (range, 0‐25) in patients receiving transfusions from related donors (p = 0.01). The ANC increment after the first, second, and seventh transfusions in patients who had community donors was significantly higher or comparable to patients who had family donors. Overall, clinical outcome was comparable between the three patient groups. Kaplan‐Meier analysis revealed no difference between all cohorts in overall 6‐month survival (p = 0.28, log‐rank) or event‐free survival (p = 0.17, log‐rank). CONCLUSION: These results suggest that future efficacy trials should consider inclusion of unrelated community donors for timely institution of granulocyte transfusion therapy.