bluuebunny/crossref_metadata_2025_split huggingface dataset:
A randomized, controlled trial to study the efficacy and safety of C1 inhibitor concentrate in treating hereditary angioedema
Authors: Kunschak M. , Engl W. , Maritsch F. , Rosen F. S. , Eder G. , Zerlauth G. , Schwarz H. P. 
Published: March 2003

BACKGROUND: No effective treatment exists in the United States for acute attacks of hereditary angioedema (HAE).STUDY DESIGN AND METHODS: To evaluate the efficacy and safety of C1 inhibitor concentrate in treating HAE, a large primary care and referral center hospital conducted a randomized, placebo‐controlled, double‐blind trial with intent‐to‐treat analysis. Of the 36 patients enrolled in the study, 23 received treatment, and 22 completed the trial. C1 inhibitor concentrate or albumin (placebo) infusions were administered in a blind fashion to HAE patients who came to the hospital for treatment no later than 5 hours after an attack began.RESULTS: Relief was almost twice as fast in persons receiving C1 inhibitor concentrate than in the controls: 7.62 hours (mean; SD 7.08) versus 15.35 hours (mean; SD 8.31), respectively. The difference for time‐to‐relief was highly significant (p = 0.007, Mann‐Whitney U test). The median time‐to‐relief was 6.17 hours (interquartile range 0.33‐15.35) in the treatment group and 15.35 hours (interquartile range 14.00–22.83) in the control group. Resolution of symptoms was one‐third faster in the C1 inhibitor concentrate group than in the placebo group: 23.98 hours (mean; SD 14.81) and 34.58 hours (mean; SD 13.56), respectively (p = 0.09, Mann‐ Whitney U test). Recovery of functional C1 inhibitor was 119.65 percent (mean; SD 50.80), and half‐life was 37.87 hours (mean; SD 19.75). Recovery of antigenic C1 inhibitor was 147.75 percent (mean; SD 97.68), and half‐life was 24.01 hours (mean; SD 9.70). There were no viral infections or serious adverse effects from the drug after 70 attacks in the treatment group and 96 attacks in the control group.CONCLUSIONS: C1 inhibitor concentrate is a safe, effective treatment for acute attacks of HAE.
White cells in fresh‐frozen plasma: evaluation of a new white cell‐reduction filter
Authors: Willis J.I. , Lown J.A.G. , Simpson M.C. , Erber W.N. 
Published: March 2003

BACKGROUND:Fresh‐frozen plasma (FFP) has generally been regarded as an acellular component. Recently, viable lymphocytes have been detected in this component and the question of irradiation of FFP for certain patients has been raised. Whether the numbers of white cells (WBCs) in FFP are sufficient to require WBC‐reduction of acellular components for patients receiving WBC‐reduced cellular components has not been determined. WBC numbers in FFP were examined, and the performance of a new commercial WBC‐reduction filter for FFP was assessed.STUDY DESIGN AND METHODS:WBC numbers in plasma processed for use as FFP and in thawed FFP were counted before and after WBC‐reduction filtration by the use of flow cytometry Fast and slow filtration was used to simulate laboratory and bedside filtration, respectively. Three different methods for plasma harvesting (soft‐spin, hard‐spin, and second‐spin methods) were assessed. The filter capacity was also examined.RESULTS:The numbers of WBCs in plasma covered a three‐log10 range (soft‐spin method, 0.04‐3.6 × 10(6); hard‐spin method, 0.47‐45.4 × 10(6); second‐ spin method, 0.4–37.2 × 10(6)). For the hard‐spin and second‐spin methods which produced the greatest plasma yields, 92 percent and 85.7 percent of bags, respectively, had counts>1 × 10(6) and 43 percent (hard‐spin method) and 45.7 percent (second‐spin method) had counts>5 × 10(6). There was no significant difference between the counts obtained in plasma and thawed FFP. The filter reduced WBC numbers to <1 × 10(5) in all but 3 of 49 bags. In the remaining three, there were <2 × 10(5) WBCs. Five bags of plasma could be processed effectively through each filter. CONCLUSION: FFP may contain WBC numbers above the threshold at which the use of WBC‐reduction filters for cellular components in some patients is necessary. Confirmation of these findings and similar investigations on plasma prepared by other methods may help in defining a role for the use of WBC‐reduction filters for FFP
Demonstration of drug‐dependent antibodies in two patients with neutrophenia and successful treatment with granulocyte–colony‐stimulating factor
Authors: Meyer O. , Gaedicke G. , Salama A. 
Published: March 2003

BACKGROUND: Many drugs have been reported as being capable of inducing immune neutropenia, but the causative drug‐dependent antibodies were rarely demonstrated.STUDY DESIGN AND METHODS: This report describes the results of serologic testing and treatment in two children with immune neutropenia related to cefotaxime and metamizole, respectively. Serum samples were tested in the presence and the absence of the drugs using the granulocyte agglutination test (GAT), the granulocyte immunofluorescence test (GIFT), and the monoclonal antibody‐specific immobilization of granulocyte antigens (MAIGA) assay.RESULTS: The serum of one child contained cefotaxime‐dependent antibodies that were detectable by the GAT and the MAIGA assay, but not by the GIFT. The serum of the other child gave positive reactions in the GAT and GIFT due to HLA antibodies and in the MAIGA assay only in the presence of metamizole. While cefotaxime‐dependent antibody was directed against CD16, the metamizole antibody was directed against CD11b and CD35. The administration of granulocyte–colony‐stimulating factor led to an abrupt increase in circulating neutrophils in both cases.CONCLUSION: The use of more than one technique is necessary for detection of drug‐dependent antibodies against neutrophils, and early administration of granulocyte–colony‐stimulating factor may result in fewer complications in these patients.
Effects of prestorage white cell reduction on platelet aggregate formation and the activation state of platelets and plasma enzyme systems
Authors: Devine D.V. , Bradley A.J. , Maurer E. , Levin E. , Chahal S. , Serrano K. , Gyongyossy‐Issa M.I.C. 
Published: March 2003

BACKGROUND: The introduction of prestorage white cell (WBC) reduction in random‐donor platelet concentrates in Canada has increased the occurrence of particulate material in PCs. The effects of filtration on platelet activation state and the activation of plasma enzyme systems were assessed.STUDY DESIGN AND METHODS: Particulate material was examined by light microscopy, electron microscopy, protein electrophoresis, and biochemical analysis. Thirty PCs (10 unfiltered, 20 filtered) were examined during processing and 5‐day storage for pH, platelet count and mean volume, morphology, activation marker expression, and hypotonic shock response. Complement activation, thrombin generation, and fibrinolysis were assessed by using specific enzyme immunoassays or chromogenic assays.RESULTS: By all analyses, the particulate material appeared to be platelet aggregates. Platelets exposed to WBC‐reduction filters expressed a significantly higher level of activation markers CD62 and CD63, altered morphology, and increased platelet microparticles throughout the storage period than did unfiltered platelets. Complement activation at the C3 level was significantly increased in filtered units with little evidence of coagulation or fibrinolytic system activation.CONCLUSION: Exposure of platelets to filters during prestorage WBC reduction increased platelet activation and mildly increased complement activation over the levels during the storage period. These alterations can contribute to the formation of irreversible platelet aggregates during processing.
Application of RHD and RHCE genotyping for correct blood group determination in chronically transfused patients
Authors: Legler T.J. , Eber S.W. , Lakomek M. , Lynen R. , Maas J.H. , Pekrun A. , Repas‐Humpe M. , Schröter W. , Köhler M. 
Published: March 2003

BACKGROUND: In chronically transfused patients, conventional blood group typing may be impossible because of mixed‐field agglutination.STUDY DESIGN AND METHODS: In 27 patients with congenital anemia and lifelong transfusion history, genotyping for D, RHD, and RHCE was performed with polymerase chain reactions. These results were compared with the blood group typing results documented in the medical record.RESULTS: Two of 27 cases had been typed D‐negative by serologic tests and D‐positive by genotyping. In 20 patients, the CDE formula had been determined serologically according to the medical record; 4 of these patients were Cc by serologic tests and C/C by genotyping. One patient typed ee by serologic tests, and genotyping revealed heterozygosity (E/e).CONCLUSION: In patients with a lifelong transfusion history, serologic blood group determination may be impossible, and pretransfusion test results are not always available or reliable. In whites, Rh‐matched transfusions are possible with genotyping. The genetic background of the RH genes has to be elucidated in other ethnic groups, such as in black patients with sickle cell disease, before genotyping can be applied without restriction.
Plateletpheresis efficiency: a comparison of the Spectra LRS and AMICUS separators
Authors: Benjamin R. J. , Rojas P. , Christmas S. , Neal J. , Broughton S. , Burgio C. , Barrett B. , Churchill W.H. 
Published: March 2003

BACKGROUND: Optimizing the yields of platelet‐pheresis by increasing collection efficiencies may provide several benefits: to patients, by increasing the dose in single‐donor platelet (SDP) units; to the collection center, by increasing the percentage of components that may be split into double units; and/or to the donor, by reducing the duration of donation.STUDY DESIGN AND METHODS: A prospective, randomized study was undertaken to compare the efficiency of platelet collection in paired donations by 21 donors on two cell separators (Spectra LRS, version [v] 5.1; and AMICUS, v2.37). The order of donation was randomly assigned; donations were performed at least 2 weeks apart. A fixed blood volume (4000 mL) was processed by utilizing standard protocols. Findings were confirmed in a retrospective, matched study that compared the two separators by using fixed collection times (90 min).RESULTS: The AMICUS and Spectra LRS separators consistently produced white cell‐reduced (<1× 106 white cells) components. The AMICUS harvested 32 percent more platelets on average (median, 4.9 × 1011; range, 1.5–8.7 × 1011) than the Spectra LRS (median, 3.7 × 1011; range, 2.1‐7.7 × 1011) (p = 0.03), with mean times of 71.5 and 66.0 minutes (p = 0.03), respectively, to process 4000 mL. Mild donor reactions tended to be more common on the AMICUS separator, which used significantly more ACD (median 482 mL vs. 389 mL; p<0.0001) than on the Spectra LRS.CONCLUSIONS: The AMICUS separator harvested more platelets per unit of blood volume processed than the Spectra LRS. Possible benefits include increased dose in each single‐donor unit, increased double‐unit harvests, and/or shorter donation time.
Sensitivity and specificity of human T‐lymphotropic virus (HTLV) types I and II polymerase chain reaction and several serologic assays in screening a population with a high prevalence of HTLV‐II
Authors: Liu H. , Shah M. , Stramer S.L. , Chen W. , Weiblen B.J. , Murphy E.L. 
Published: March 2003

BACKGROUND: Since 1988, all blood donations in the United States have been screened for antibodies to human T‐lymphotropic virus type I (HTLV‐I). However, the sensitivity of current serologic tests for the detection of HTLV type II (HTLV‐II) antibodies and the diagnostic utility of direct tests for HTLV‐I and ‐II using polymerase chain reaction (PCR) are poorly defined.STUDY DESIGN AND METHODS: Five hundred sixty‐nine HTLV‐I‐ or ‐II‐seropositive and 687 age‐ and sex‐matched seronegative samples from a high‐risk population at an inner‐city emergency department were selected. All samples were tested with four HTLV enzyme immunoassays (EIAs), one Western blot assay and one type‐specific Western blot assay, one HTLV type‐specific EIA, and a research HTLV‐I/II PCR kit.RESULTS: Sensitivity of the various EIAs ranged from 95.1 to 99.5 percent, and specificity ranged from 97.2 to 99.4 percent. PCR performed in duplicate without selective retesting had lower sensitivity (85.1%) and specificity (88.0%). However, PCR detected 20 (3.2%) HTLV‐I‐positive and 47 (7.5%) HTLV‐II‐positive samples among the 627 samples that were negative in all EIAs. The type‐specific EIA and PCR assay had the highest rate of concordance in classifying samples as either HTLV‐I or ‐II, with the type‐specific EIA and type‐specific Western blot having the next highest rates of concordance.CONCLUSION: In this sample set from a population at high risk for HTLV‐II, screening with HTLV‐I/II PCR had lower sensitivity and specificity than that with EIAs. However, 4.1 to 10.8 percent of samples were PCR positive but seronegative for HTLV‐I or –II, and their true infection status remains undetermined.
Processing of major ABO‐incompatible bone marrow for transplantation by using dextran sedimentation
Authors: Tsang K.S. , Li C.K. , Wong A.P. , Leung Y. , Lau T.T. , Li K. , Shing M.M.K. , Chik K.W. , Yuen P.M.P. 
Published: March 2003

BACKGROUND: Various open and semi‐closed methods are used for red cell (RBC) depletion and hematopoietic progenitor cell (HPC) enrichment of bone marrow (BM) in vitro, but with variable efficacy. A simple, efficient, and safe method using dextran 110k was developed.STUDY DESIGN AND METHODS: An equal volume of 4.5‐percent dextran was applied to major ABO‐incompatible BM in transfer bags and sedimentation was allowed for 30 minutes. RBCs, nucleated cells (NCs), and mononuclear cells (MNCs) from BM allografts before and after dextran sedimentation (DS) were counted. Flow cytometry, short‐term cultures, and long‐term cultures were performed to assay the respective recovery of CD34+ cells, colony‐forming units (CFUs), and long‐term culture‐initiating cells (LTC‐ICs).RESULTS: Sixteen BM collections were processed. The mean volume was 666 mL (range, 189‐1355 mL). The mean ± 1 SD post‐DS NC, MNC, CD34+ cell, and CFU counts per kg of the recipient's body weight were 4.11 ± 1.74 × 108, 8.98 ± 3.68 × 107, 2.90 ± 1.95 × 106, and 2.03 ± 2.01 × 105, respectively, with the corresponding post‐DS recovery being 90.6 percent, 90 percent, 92.4 percent, and 100.8 percent. The numbers of LTC‐ICs in cultures (up to 12 weeks) of pre‐DS and post‐DS samples of five BM allografts were comparable (p = 0.91). Residual RBCs were 5.1 ± 4.6 (0.1‐14) mL with depletion of 96.5 ± 3.2 percent. There was no significant difference in the mean absolute RBC count in post‐DS BM allografts and in four ficoll‐treated BM allografts (8.09 × 1010 vs. 4.9 × 109; p = 0.206) and in eight major ABO‐incompatible peripheral blood HPC collections (8.09 × 1010 vs. 9.81 × 1010; p = 0.87). No posttransplant hemolysis was encountered. Engraftment occurred at 22 ± 7 days, which is similar to that of four transplants with ficoll‐treated BM allografts (22 ± 9; p = 0.611) and 54 unprocessed BM allografts (19 ± 6; p = 0.129).CONCLUSION: DS is an efficient method of depleting RBCs in major ABO‐incompatible BM allografts without significant loss of HPCs.
Transfusion with blood from a donor with chronic myelogenous leukemia: persistence of the bcr/abl translocation in the recipient
Authors: Vargas Sara O. , Cannon Marie E. , Benjamin Richard J. , Longtine Janina A. 
Published: March 2003

BACKGROUND: Transfusion of cells harvested from patients with chronic myelogenous leukemia (CML) as a therapeutic measure for patients with granulocytopenia was popular in the 1970s, when studies examining the persistence of transfused donor cells were limited by a lack of molecular techniques. Blood samples from a patient who recently received an inadvertent transfusion of CML cells were evaluated for the presence of the bcr/abl translocation characteristic of CML.CASE REPORT: The patient, a 67‐year‐old man with a history of congestive heart failure, myocardial infarct, hypertension, diabetes mellitus, and chronic renal failure, was transfused for bleeding from colonic angiodysplasia. A volunteer blood donor reported that he had been diagnosed with CML 10 days after his donation. Three days after the donation, blood components from the donor with CML had been administered to the patient as nonirradiated red cells and platelets. Evaluation of donor blood by a reverse‐transcriptase polymerase chain reaction showed the b3a2 transcript, indicating a bcr/abl translocation. Periodic testing of the patient's peripheral blood by the same technique demonstrated the presence of the b3a2 transcript on Days 74 and 75 after transfusion. The patient died of congestive heart failure 8 months after the transfusion.CONCLUSION: In this rare case of accidental transfusion of neoplastic cells, the findings document the persistence of the donor's neoplastic clone in the recipient for 75 days.
High deferral rate for maternal–neonatal donor pairs for an allogeneic umbilical cord blood bank
Authors: Jefferies Leigh C. , Albertus Mary , Morgan Mark A. , Moolten David 
Published: March 2003

BACKGROUND: To fully evaluate the safety and efficacy of umbilical cord blood (UCB) as a source of hematopoietic progenitor cells, UCB banks are being established worldwide to provide a readily accessible resource of stem and progenitor cells for allogeneic transplantation. Guidelines for UCB donor criteria have been proposed to minimize the possibility of disease transmission to UCB recipients.STUDY DESIGN AND METHODS: In preparation for the establishment of an allogeneic UCB bank, 285 maternal–neonatal donor pairs were evaluated in our tertiary‐care hospital, which was chosen because of the high percentage of African Americans among the maternal population. Maternal, neonatal, and family histories were obtained by confidential interview and medical record review to determine the number of eligible donor pairs on the basis of a conservative interpretation of proposed donor criteria.RESULTS: Only 44 percent of donor pairs were considered eligible. The most common deferral factors were maternal, and they included fever at delivery, history of chronic disease, and history of sexually transmitted disease. In most cases, more than one deferral factor was identified.CONCLUSIONS: High‐risk maternal populations, which may provide access to ethnic minorities targeted for some UCB banks, may contain low percentages of eligible donors. Further refinement of donor criteria will be important in the evolution of UCB banking and transplantation.
Safety issues of plateletpheresis: comparison of the effects of two cell separators on the activation of coagulation, fibrinolysis, and neutrophils and on the formation of neutrophil‐platelet aggregates
Authors: Stohlawetz Petra , Kapiotis Stylianos , Seidl Dagmar , Hergovich Nicole , Zellner Maria , Eichler Hans‐Georg , Stiegler Gabriele , Leitner Gerda , Höcker Paul , Jilma Bernd 
Published: March 2003

BACKGROUND: Although many donors undergo repeated plateletpheresis, data on the consequences of plateletpheresis for the donor's health remain scarce. Thus, the effect of plateletpheresis on the activation of coagulation, fibrinolysis, and neutrophils was investigated.STUDY DESIGN AND METHODS: Part 1: Sixteen healthy men were randomly assigned to undergo plateletpheresis on a cell separator (AMICUS, Fenwal Baxter; or MCS 3p, Haemonetics). The effects of plateletpheresis on plasma levels of prothrombin fragment (F1+2), d‐dimer, plasmin‐plasmin inhibitor (PPI) complexes, and plasminogen activator inhibitor (PAI‐1); on the activation of neutrophils (% l‐selectin+); and on the frequency of platelet‐neutrophil aggregates (% CD41 + neutrophils) were compared. Part 2: Ten healthy men received infusions of ACD‐A and placebo without apheresis in a randomized, double‐blind crossover study to control for the pharmacologic effects of citrate.RESULTS: Part 1: No change in F1+2 occurred (p>0.05), which indicated that plateletpheresis did not enhance coagulation. Levels of d‐dimer, PPI, and PAI‐1 decreased over time on the AMICUS (p<0.001). Plateletpheresis did not activate neutrophils (p>0.05), but it decreased the percentage of CD41+ neutrophils (p<0.003). An approximately 80‐percent drop in mononuclear cells was observed in the extracorporeal circulation of the AMICUS (p<0.001 vs. baseline and p = 0.005 vs. MCS 3p), and circulating lymphocyte and monocyte counts decreased concomitantly. Part 2: Infusion of ACD‐A slightly decreased d‐dimer levels (p<0.05), and both infusions decreased the circulating lymphocyte counts.CONCLUSION: Plateletpheresis can be regarded as safe with respect to the activation of coagulation or neutrophils. The consequences for the donor's health of the decrease in d‐dimer, PPI, and PAI‐1 may deserve further investigation.
GVHD after transfusion of stored RBC concentrates in asolution of mannitol, adenine, phosphate, citrate, glucose,and NaCl following trauma
Authors: Kita T. , Nei J. , Matsu T. , Yoshiba H. , Matsuda T. , Yahagi H. , Uchida S. , Nakao S. 
Published: March 2003

BACKGROUND: It has not previously been reported that WBC‐reduced RBC preparations can cause transfusion‐associated GVHD, even in an immunocompetent individual.CASE REPORT: A 74‐year‐old man suffered a hemorrhage from the mesentery of the transverse colon after a traffic accident. During surgery, he received 10 units of RBCs from 10 donors in a solution containing mannitol, adenine, phosphate, citrate, glucose and NaCl (MAP). MAP RBCs had been stored for 7 to 8 days before use. On the 27th day after surgery, an erythematous, pruritic rash appeared over the face, neck, and trunk, which was associated with low‐grade fever and pancytopenia. Transfusion‐associated GVHD was strongly suspected and was confirmed by skin biopsy. To determine the origin of lymphocytes causing GVHD, several microsatellite loci were amplified from DNA of the patient's nails and blood and from blood samples of all 10 RBC donors by using PCR. Amplified alleles derived from the patient's blood were identical to those from one of the 10 samples.CONCLUSION: These findings indicate that transfusions of MAP‐RBCs can cause transfusion‐associated GVHD in an elderly but immunocompetent host.