bluuebunny/crossref_metadata_2025_split huggingface dataset:
Redefining the HIV‐infectious window period in the chimpanzee model: evidence to suggest that viral nucleic acid testing can prevent blood‐borne transmission
Authors: Murthy K.K. , Henrard D.R. , Eichberg J.W. , Cobb K.E. , Busch M.P. , Allain J.P. , Alter H.J. 
Published: March 2003

BACKGROUND: Although it is rare, blood‐transmitted HIV infection can occur when a donor presents in the window period between HIV‐1 exposure and the first appearance of detectable p24 antigen.STUDY DESIGN AND METHODS: To study this seronegative window period, a chimpanzee (X034) was inoculated with 38 median tissue culture infective doses of HIV‐1 IIIB; serum and peripheral blood mononuclear cells were obtained one to two times per week for 12 weeks and then biweekly for 12 weeks. Infectivity was monitored by the detection of serum HIV RNA, cell‐associated HIV DNA, p24 antigen, and anti‐HIV and by co‐culture methods.RESULTS: No HIV markers were noted until 5 weeks after inoculation, at which time virus was isolated and HIV RNA and DNA were detected in plasma and cells, respectively. Anti‐HIV and HIV p24 antigen were not present until 8 weeks after inoculation. Plasma and cells obtained from Chimpanzee X034 3 or 4 weeks after exposure were then sequentially inoculated into a second chimpanzee (X176); no HIV infection was observed in this animal during serial follow‐up for 24 weeks after each inoculation. In contrast, when the fifth‐week HIV‐1 RNA‐ and DNA‐positive sample was inoculated, Chimpanzee X176 was unequivocally infected with HIV‐1.CONCLUSIONS: Nucleic acid testing narrowed the seronegative window by 3 weeks (37%). More important, there was no demonstrable infectivity in either plasma or peripheral blood mononuclear cells obtained before molecular markers were detectable. This suggests that the infectious window may be considerably shorter than the total window as measured from exposure and that nucleic acid testing might not only shorten the seronegative window, but totally prevent transfusion‐transmitted HIV infection.
Determination of reasons for cessation of participation in serial plasmapheresis programs
Authors: Rodell M.B. , Lee M.L. 
Published: March 2003

BACKGROUND: An earlier retrospective review of records of over 500 remunerated donors participating in plasmapheresis programs at various levels of frequency for 10 or more years showed that there were no significant differences in mean values for total protein, microhematocrit, body weight, and individual serum proteins, regardless of the number of annualized donations for each of four frequency groups. Although these data demonstrated that donors undergoing serial plasmapheresis for 10 or more years were able to successfully continue in such programs, the review did not include information relative to individuals who had discontinued their participation. The current study investigated reasons that donors drop out of plasmapheresis programs.STUDY DESIGN AND METHODS: Donors who had successfully undergone plasmapheresis at least 20 times within a recent 6‐month period but who had failed to appear for at least 30 days subsequent to their last donation were defined as potential subjects for the study. Staff members at the participating center contacted the donors, inviting them to return to the center to participate in a survey. Donors were also asked for a blood sample upon their arrival at the plasma center; samples were tested for total and various serum proteins.RESULTS: A total of 409 eligible subjects appeared at the centers for the survey, and 375 blood samples were analyzed for proteins. Survey responses indicated that the predominant reasons for an end to participation were socioeconomic in nature. Serum protein findings were compared to the most recent results obtained while the donors were active in the plasmapheresis program. Slightly higher mean serum protein findings were seen for samples collected on the survey date.CONCLUSION: A review of the aggregate responses obtained in the survey indicates that the predominant reasons that donors ceased to participate were not health‐related: the remuneration was no longer needed, and work schedule conflicts, time constraints, and relocation were frequently cited.
The dose of granulocyte–colony‐stimulating factor after chemopriming treatment does not influence apheresis yield of progenitor cells: a retrospective study of 91 cases
Authors: Lefrère F. , Belanger C. , Audat F. , Hermine O. , Cavazzana‐Calvo M. , Arnulf B. , Buzyn A. , Varet B. 
Published: March 2003

BACKGROUND: The optimal dose of post‐chemotherapy granulocyte–colony‐stimulating factor (G–CSF) administration before peripheral blood progenitor cell (PBPC) collection has not been determined as yet, although 5 μg per kg per day has been recommended as the standard dose. This study retrospectively analyzed the effect of G–CSF dose on peripheral blood CD34+ cell collection from 91 patients with hematologic malignancies.STUDY DESIGN AND METHODS: Various doses of G–CSF were administered after several chemotherapeutic PBPC mobilization regimens. According to the dose of G–CSF administered, patients were assigned to two groups. Group 1 included 46 patients who received a low dose of G–CSF (median, 3.6 [range, 2.8‐4.6] μg/kg/day). Group 2 included 45 patients who received a standard G–CSF dose of 6.0 (5.5‐8.1) μg per kg per day. Patients in the two groups were matched for age, diagnosis, previous therapy, and chemotherapeutic PBPC mobilization regimens.RESULTS: No difference was observed in the median number of CD34+ cells harvested from each group. The number of leukapheresis procedures necessary to obtain a minimum of 3 × 106 CD34+ cells per kg was the same in both groups, and the percentage of patients who failed to achieve adequate PBPC collections was similar in the two groups.CONCLUSION: The administration of low‐dose G–CSF after chemotherapy appears equivalent to administration of the standard dose in achieving satisfactory PBPC collection. This approach could allow significant savings in medical cost. A randomized and prospective study is necessary, however, to assess the validity of these conclusions.
Clinical evaluation of a solid‐phase test for red cell antibody screening of pregnant women
Authors: Shanwell Agneta , Sallander Suzanne , Bremme Katarina , Westgren Magnus 
Published: March 2003

BACKGROUND: The aims of this study were to evaluate the results of a new solid‐phase screening test for detecting atypical red cell (RBC) antibodies in a large number of pregnant women and to compare these results to the clinical outcome of the newborn.STUDY DESIGN AND METHODS: A total of 38,700 infants born in Stockholm were studied retrospectively. Of these infants, 18,500 were born to pregnant women screened with the solid‐phase test. Data were collected on all newborns with a positive direct antiglobulin test (DAT) and on infants requiring an exchange transfusion or a blood transfusion. These data were correlated to the screening results for the mothers.RESULTS: Of 409 DAT‐positive newborns, a serologic explanation for the positive DAT was found in 349. Three hundred four cases were due to ABO incompatibility between mother and child; 19 of these infants needed an exchange transfusion. Forty‐two cases were due to unexpected maternal RBC antibodies; 11 of these infants were given an exchange transfusion. All 11 were identified before birth. Three other infants had DAT‐positive tests due to ABO incompatibility and to unexpected maternal RBC antibodies.CONCLUSION: ABO incompatibility is a major indication for exchange transfusion in DAT‐positive newborns. There was no evidence that the solid‐phase screening test had failed to detect any clinically significant RBC antibodies. Finally, the results of this study do not indicate a need for routine screening of D+ women more than once during each pregnancy.
Prevalence of HLA sensitization in female apheresis donors
Authors: Densmore Tamara L. , Tim Goodnough Lawrence , Ali Suhail , Dynis Marian , Chaplin Hugh 
Published: March 2003

BACKGROUND: Transfusion‐related acute lung injury (TRALI) is a serious complication of plasma‐containing blood components. Studies have implicated HLA antibodies along with biologically active lipids in stored blood in the pathogenesis of TRALI. It has been proposed that the exclusion of HLA‐untested, multiparous donors of plasma‐rich components, including plasma and single‐donor apheresis platelets, would substantially reduce the risk of TRALI.STUDY DESIGN AND METHODS: To investigate the feasibility of such an exclusion, 332 female plateletpheresis donors with a record of over 9000 donations, none of which were associated with TRALI, were studied.RESULTS: Seventeen percent of female donors demonstrated HLA sensitization. Parity and HLA sensitization were significantly correlated (p<0.0001), with sensitized donors having an average of 2.9 (± 0.6 95% CI) prior pregnancies and unsensitized donors having an average of 1.8 (± 0.2 95% CI) prior pregnancies. The percentage of HLA‐sensitized women with 0, 1 to 2, and >3 pregnancies was 7.8, 14.6, and 26.3, respectively.CONCLUSION: These findings confirm the hypothesis that multiparous women (>3 pregnancies) represent an increased potential risk for TRALI. However, the exclusion of multiparous plateletpheresis donors would eliminate one‐third of our female donor pool. Screening such donors for HLA sensitization may represent the optimal approach for identifying donors at risk for causing TRALI, but this still would result in the deferral of 8 percent of female plateletpheresis donors. At present, prospective screening to identify donors at risk for causing TRALI is not justified.
Greater increase in cytokine concentration after salvage with filtered whole blood than with washed red cells, but no difference in postoperative hemoglobin recovery
Authors: Åvail Anders R. , Hyllner Monica , Bengtson Jan Peter , Carlsson Lars , Bengtsson Anders 
Published: March 2003

BACKGROUND: Inflammatory mediators are released in association with intraoperative and postoperative salvage of blood. Whether these mediators (cytokines) participate in the modulation of erythropoiesis or not has been investigated.STUDY DESIGN AND METHODS: Twenty‐seven patients who were to undergo total knee replacement surgery were randomly assigned to postoperative blood salvage with either filtered whole blood or washed red cells. Patients with postoperative blood loss <400 mL were considered a control group. The control group did not receive any transfusions. Plasma concentrations of the anaphylatoxin C3a, the C5b‐9 terminal complement complex, and the cytokines interleukins 6 and 8, hemoglobin, reticulocytes, and red cell volume fraction in the patients were repeatedly analyzed before and after surgery.RESULTS: Significantly increased concentrations of interleukin 6 appeared in all three groups, which was interpreted as a response to the surgical trauma. The increase was significantly greater in the group that received filtered whole blood after return of shed blood. The recovery of hemoglobin levels did not differ in the groups.CONCLUSION: The transfusion of filtered whole blood leads to the formation of interleukin 6 in the circulation, but postoperative hemoglobin recovery was similar in all groups.
Hydroxyethyl starch reduces the chemotaxis of white cells through endothelial cell monolayers
Authors: Hofbauer Roland , Moser Doris , Hornykewycz Stephan , Frass Michael , Kapiotis Stylianos 
Published: March 2003

BACKGROUND: Polymorphonuclear leukocytes (PMNs) play a tremendous role during inflammatory processes. PMNs have to pass a monolayer of endothelial cells to migrate into the extravascular space. Hydroxyethyl starch (HES) is frequently used as a volume expander in critically ill patients.STUDY DESIGN AND METHODS: The aim of this study was to investigate whether HES influences the chemotaxis of PMNs through endothelial cell monolayers by using a test system that allows the simultaneous treatment of both cell types. Human umbilical endothelial cells were cultured on microporous membrane filters. PMNs were isolated and PMN chemotaxis was studied.RESULTS: The number of untreated PMNs that migrated through untreated endothelial cell monolayers in response to a chemoattractant was used as a control and set as 100 percent. In clinically relevant concentrations, HES was able to significantly decrease PMN chemotaxis through endothelial cell monolayers, showing a dose‐dependent effect (0.1 mg/mL: 99.6 ± 10.9%, p = NS compared to control; 1 mg/mL: 82.4 ± 8.3%, p<0.05 compared to control; 10 mg/mL: 62.9 ± 11.7%, p<0.05).ln this assay, both cell types (PMNs and endothelial cells in the monolayer) were treated simultaneously, which simulated the clinical situation after an intravenous injection of HES. The treatment of one cell type, PMNs (89.6 ± 8.8%, p<0.05) or endothelial cells in the monolayer (76.2 ± 9.4%, p<0.05), suggests that the influence on endothelial cells is greater.CONCLUSION: HES is able to significantly reduce the chemotaxis of PMNs through endothelial cell monolayers. The possible clinical consequence of a moderate reduction in endothelium‐mediated PMN chemotaxis in critically ill patients remains to be evaluated.
The number of platelet glycoprotein Ia molecules is associated with the genetically linked 807 C/T and HPA‐5 polymorphisms
Authors: Corral Javier , Rivera José , González‐Conejero Rocio , Vicente Vicente 
Published: March 2003

BACKGROUND: The neutral 807 C/T (Phe224) polymorphism (807 C/T polymorphism) of the glycoprotein (GP)Ia gene has been recently associated with the number of GPIa molecules on the platelet surface. The association of the number of GPIa molecules with other GPIa polymorphisms, such as HPA‐5 (Glu/Lys505) (HPA‐5 polymorphism), involved in alloimmune thrombocytopenias is unknown.STUDY DESIGN AND METHODS: The association of the HPA‐5 polymorphism with the number of GPIa molecules on the platelet surface in 159 white blood donors was investigated. The genetic linkage between the HPA‐5 and the 807 C/T polymorphisms in 316 individuals was also determined.RESULSTS: Both the 807 C/T and HPA‐5 polymorphisms correlate with the number of GPIa molecules on the platelet surface. The 807 T and HPA‐5b alleles are associated with increased numbers of GPIa molecules on the platelet surface. Moreover, the HPA‐5b allele is genetically linked to 15.8 percent of the 807 C alleles. Therefore, the number of GPIa molecules on the platelet surface is dependent on both GPIa polymorphisms as follows: 807 T/T, HPA‐5 a/a > 807 C/T, HPA‐5 a/b > 807 C/T, HPA‐5 a/a > 807 C/C, HPA‐5 a/b > 807 C/C, HPA‐5 a/a.CONCLUSION: Two GPIa polymorphisms (807 C/T and HPA‐5) responsible for the variability in the numbers of GPIa/lla molecules on the platelet surface in whites have been identified. Despite the genetic linkage between the two polymorphisms, their influence on the number of GPIa molecules on the platelet surface may occur through different mechanisms.
TT virus infections among blood donors in Iceland:prevalence, genotypes, and lack of relationship to serum ALT levels
Authors: Löve A. , Stanzeit B. , Li L. , Ólafsdóttir E. , Gudmundsson S. , Briem H. , Widell A. 
Published: March 2003

BACKGROUND: The TT virus (TTV) is a newly identified blood‐borne virus. Its association with disease is still unknown, and screening of blood donors has not been implemented. Several genotypes of the TTV have been identified.STUDY DESIGN AND METHODS: Three hundred seventy healthy blood donors were randomly selected and tested for TTV by the PCR method. Sequencing of a part of the genome was performed to identify various genotypes of the virus. ALT levels were determined in both infected and uninfected individuals.RESULTS: The TT virus (TTV), was detected in the sera of 23 (6.2%) of 370 healthy Icelandic blood donors; this prevalence is lower than that reported in Japan but higher than that in Scotland. The virus was found in all groups over the age of 19. Sequencing and phylogenetic analysis of 202 bp from open reading frame 1 demonstrated genotypes 1b and 2b 2c and genotype 4 isolates, with the latter bearing 89‐percent nucleotide homology with other genotype 4 sequences deposited at GenBank. One sample showed a mixed genotype 1b/2c infection. Serum ALT levels were within normal limits in all infected individuals.CONCLUSION: The TTV carrier state does not cause significant liver injury.
A multicenter study evaluating three methods for counting residual WBCs in WBC‐reduced blood components: Nageotte hemocytometry, flow cytometry, and microfluorometry
Authors: Dzik S. , Moroff G. , Dumont L. ,   for the Biomedical Excellence for Safer Transfusion (BEST) Working Party of the ISBT
Published: March 2003

BACKGROUND: A multicenter study was conducted to evaluate the performance characteristics of flow cytometry and microfluorimetry for counting low concentrations of WBCs and to compare the results with Nageotte hemocytometry.STUDY DESIGN AND METHODS: A two‐phase study involving 10 centers located in the United States and in Europe was performed. Coded samples of RBCs and platelets were distributed by 24‐hour (Phase 1) or 2‐day (Phase 2) courier service to each test site for analysis. Samples were prepared to include concentrations of WBCs slightly above and below the concentration corresponding to the threshold standards for WBC‐reduced RBCs and platelets. All centers tested samples by Nageotte hemocytometry plus one or both of two automated methods.RESULTS: Both flow cytometry and microfluorometry gave better results than Nageotte hemocytometry in testing freshly prepared samples. At WBC concentrations >5 per μL (RBCs) or >3 per μL (platelets), the intersite CV was <20 percent for the automated methods but >30 percent for the Nageotte hemocytometer method (p<0.001). Accuracy was greater for the automated methods than for the Nageotte hemocytometer method (p<0.001). Nageotte hemocytometry showed a bias to underestimation relative to the results obtained with the automated methods. All methods had poorer performance in testing samples that required ≥2 days' shipment than in testing of those requiring overnight shipment.CONCLUSION: Automated methods for counting residual donor WBCs in WBC‐reduced cellular components offer advantages of improved precision and greater accuracy than are seen with the Nageotte hemocytometer method. Automated methods are less labor‐intensive but more costly than microscopic methods. Preparation and shipping methods will need further refinement for samples to be counted more than 24 hours after sample collection.
Immune‐mediated agglutination of cytoskeleton‐free RBC microvesicles
Authors: Jaime J.C. 
Published: March 2003

BACKGROUND: The factors contributing to RBC agglutination are complex. The RBC cytoskeleton's participation in and contribution to this phenomenon are difficult to separate from those of the plasma membrane. Immunoreactive, cytoskeleton‐free, band 3‐enriched microvesicles can be generated from normal RBCs. Band 3 has been defined as an important antigen in autoimmune hemolytic anemia (AIHA).STUDY DESIGN AND METHODS: RBC microvesicles devoid of major cytoskeletal proteins were generated and sensitized with eluates obtained from AIHA patients, DAT‐positive blood donors, and antisera to common RBC antigens. Monoclonal anti‐human IgG was added and agglutination was investigated. Autoantibody‐specific binding was evaluated by employing 125I protein A.RESULTS: RBC vesicle agglutination with a 4+ anti‐human globulin score was obtained with 10 autoantibody eluates from AIHA patients and anti‐D (3+), but not with eluates from 20 DAT‐positive blood donors or antisera directed to eight other common RBC antigens. Microvesicles sensitized with AIHA eluates bound 67 to 167 times as much 125I protein A radioactivity as did those incubated with buffered normal saline and 18 to 45 times more than vesicles incubated with normal serum.CONCLUSION: The major proteins of the RBC cytoskeleton are not required for supporting IgG immune‐mediated agglutination of RBC microvesicles.
Passenger lymphocyte syndrome with severe hemolytic anemia due to an anti‐Jka after allogeneic PBPC transplantation
Authors: Leo A. , Mytilineos J. , Voso M.T. , Weber‐Nordt R. , Liebisch P. , Lensing C. , Schraven B. 
Published: March 2003

BACKGROUND: After allogeneic peripheral blood progenitor cell (PBPC) transplantation, a patient developed a severe hemolytic transfusion reaction due to passenger lymphocyte syndrome.CASE REPORT: A 50–year‐old woman with secondary acute myeloid leukemia transforming from a myelodysplastic syndrome received an ABO‐compatible PBPC graft from her HLA‐identical sister. For prophylaxis of GVHD, the patient was treated with cyclosporine and methotrexate. Eighteen days after the transplant, the patient experienced a severe hemolytic transfusion reaction due to an alloantibody (anti‐Jka) produced by donor lymphocytes.RESULTS: The patient was typed as group A, Jk(a+) before transplantation; the donor was typed as group A, Jk(a–). On Day 18 after transplantation, the immunohematologic screening revealed a positive DAT (C3d 3+) and an alloanti‐Jka. Hemolysis in the patient at that time was indicated by a drop in the Hb and an increase in the LDH level (maximum, 592 IU/L on Day 23).CONCLUSION: The course of hemolysis and the time of appearance of an alloantibody in this patient meet the criteria for passenger lymphocyte syndrome. In most cases, this syndrome is triggered by ABO system antibodies. This is the first reported case of passenger lymphocyte syndrome after PBPC transplantation that was due to an alloantibody that did not belong to the ABO system.
Immune hemolytic anemia caused by sensitivity to a metabolite of etodolac, a nonsteroidal anti‐inflammatory drug
Authors: Cunha P.D. , Lord R.S. , Johnson S.T. , Wilker P.R. , Aster R.H. , Bougie D.W. 
Published: March 2003

BACKGROUND: Immune hemolytic anemia can be caused by sensitivity to many different drugs. In some instances, the sensitizing compound can be identified by in vitro testing, but results are often negative. One reason for this is that a drug metabolite formed in vivo can be the sensitizing agent, but the responsible metabolites have rarely been identified at a chemical level. This report describes a patient who developed severe, Coombs‐positive hemolytic anemia on two occasions after taking the nonsteroidal anti‐inflammatory drug etodolac. Studies were performed to characterize etodolac metabolites to which this patient was sensitive.CASE REPORT: Serum was tested for antibody in the presence and absence of drug using conventional methods and urine from individuals taking etodolac as a source of drug metabolites. Urinary metabolites of etodolac were identified by high‐pressure liquid chromatography analysis. Glucuronide conjugates of etodolac and the 6‐OH metabolite of etodolac were synthesized in a rat liver microsomal system to obtain reference standards.RESULTS: The patient's serum gave only trace (±) reactions with normal RBCs in the presence of etodolac but reacted strongly (4+) in the presence of urine from an individual taking this drug. The active urinary metabolites were identified as etodolac glucuronide and 6‐OH etodolac glucuronide.CONCLUSION: This patient appears to have experienced acute, severe immune hemolytic anemia on two occasions because of sensitivity to the glucuronides of etodolac and 6‐OH etodolac. In patients suspected of having drug‐induced immune hemolytic anemia, RBC‐reactive antibodies can sometimes be detected by using urine from an individual taking the implicated medication as the source of drug metabolites in in vitro reactions. For patients who present with acute immune hemolysis, a careful history of drug exposure should be taken, and, where indicated, confirmatory testing should be performed to identify the sensitizing drug and prevent inadvertent reinduction of hemolysis at a later time.