CLINICAL EXPERIENCE WITH TRANSFUSION OF LEUKOCYTE-POOR PLATELET CONCENTRATES PREPARED BY FILTRATION WITH PROSTACYCLIN

1987 ◽  
Author(s):  
M Van Marwijk Kooy ◽  
H c van Prooijen ◽  
T I Reimens ◽  
J W N Akkerman

Repeated transfusions with platelets from randomly selected donors lead to HLA alloimmunization in about 50% of thepatients. This is caused by lymphocytes that contaminate the platelet concentrates. Attempts to remove the leukocytes from the platelet concentrates by additional centrifugation steps lead to substantial loss of platelets.We report here a new procedure for removal of almost all leukocytes with excellent platelet recoveries. Single donor concentrates are treated with 50 ng/ml prostacyclin in order to inactivate the platelets transiently. The concentrates are then passed through a cellulose acetate filter to remove the leukocytes. In 30 fresh concentrates this treatment reduced the contamination by leukocytes to less than 0.1 million per concentrate with a platelet recovery of 89± 1% (mean ±SEM). In concentrates stored for 3 days the contamination was reduced to about 5 million per concentrate. Thirty filtered platelet concentrates, obained from single donors by platelet apheresis using a Haemonetics U 50, were transfused to ten thrombocytopenic patients within 1 hour after filtration and were well tolerated. No signs of hypotension or other side effects were observed. The transfusions led to corrected count increments of (22.0±1.1) x 10 per ml blood after one hour and normal survival thereafter. In four out of five patients these concentrates reduced the bleeding time.We conclude that transient inactivation of platelets by prostacyclin enables optimal removal of leukocytes and may help to reduce alloimmunization during frequent transfusions with platelet concentrates.Supported by the Praeventionfund (grant 28953), The Hague.

Blood ◽  
1987 ◽  
Vol 70 (1) ◽  
pp. 243-246 ◽  
Author(s):  
HC van Prooijen ◽  
TI Riemens ◽  
JW Akkerman

Abstract Repeated transfusions with platelets from randomly selected donors lead to HLA alloimmunization in about 50% of patients due to lymphocyte contamination of platelet concentrates. Attempts to remove the leukocytes from the platelet concentrates by additional centrifugation steps led to substantial loss of platelets. We report a new procedure for removal of almost all leukocytes with excellent platelet recoveries. Single donor concentrates are treated with 50 ng/mL prostacyclin to inactivate the platelets transiently. The concentrates are then passed through a cellulose-acetate filter to remove the leukocytes. In 30 concentrates this treatment reduced the contamination by leukocytes to less than 0.1 million per concentrate with a platelet recovery of 89% +/- 1% (mean +/- SEM). Thirty filtered platelet concentrates transfused to ten thrombocytopenic patients within one hour after filtration were well tolerated and led to corrected count increments of (22.0 +/- 1.1) X 10(6)/mL blood after one hour and normal survival thereafter. In four of five patients these concentrates reduced the bleeding time. We conclude that transient inactivation of platelets by prostacyclin enables optimal removal of leukocytes and may help to reduce alloimmunization during frequent transfusions with platelet concentrates.


Blood ◽  
1987 ◽  
Vol 70 (1) ◽  
pp. 243-246
Author(s):  
HC van Prooijen ◽  
TI Riemens ◽  
JW Akkerman

Repeated transfusions with platelets from randomly selected donors lead to HLA alloimmunization in about 50% of patients due to lymphocyte contamination of platelet concentrates. Attempts to remove the leukocytes from the platelet concentrates by additional centrifugation steps led to substantial loss of platelets. We report a new procedure for removal of almost all leukocytes with excellent platelet recoveries. Single donor concentrates are treated with 50 ng/mL prostacyclin to inactivate the platelets transiently. The concentrates are then passed through a cellulose-acetate filter to remove the leukocytes. In 30 concentrates this treatment reduced the contamination by leukocytes to less than 0.1 million per concentrate with a platelet recovery of 89% +/- 1% (mean +/- SEM). Thirty filtered platelet concentrates transfused to ten thrombocytopenic patients within one hour after filtration were well tolerated and led to corrected count increments of (22.0 +/- 1.1) X 10(6)/mL blood after one hour and normal survival thereafter. In four of five patients these concentrates reduced the bleeding time. We conclude that transient inactivation of platelets by prostacyclin enables optimal removal of leukocytes and may help to reduce alloimmunization during frequent transfusions with platelet concentrates.


1987 ◽  
Author(s):  
A Ghirardini ◽  
T DiPaolantonio ◽  
S Solinas ◽  
M Papacchini ◽  
C Cutrera ◽  
...  

We have evaluated the pharmacological efficacy of a concentrated DDAVP preparation (40 μg/mL) (herein referred to as C-DDAVP) administered subcutaneously (s.c.) in mild (n=23) and moderate (n=2) hemophilia A patients. A comparison between the response to s.c. C-DDAVP and the "dilute" DDAVP (4 μg/ml) (administered s.c. in 16 patients with mild (n=13) and moderate (n=3) hemophilia A and i.v. in 18 patients with mild (n=16) and moderate (n=2) was also carried out. In all instances Desmopressin was given at a dose of 0.3 μg/kg b.w. in absence of bleeding. The increase of F. VIII:C (expressed as post/pre ratio) after s.c. C-DDAVP was 2,55 at 30', 3,50 at 60'and 3,21 at 120'. The comparison among the three schedules of DDAVP administration showed that s.c. C-DDAVP elicited an increase of F. VIII :C at least as high as that induced by the dilute DDAVP with differences not statistically significant.C-DDAVP was also administered s.c. in 4 patients with type I vWD (platelet normal subtype) with a normalization of bleeding time 60' after s.c. C-DDAVP, concomitant with a rise of activities related to F. VIII/vWF complex. Side effects were modest and transient. We can conclude that s.c. C-DDAVP is equally effective and safe in comparison with the dilute brand with the advantage of the minimal adminstration volume (<1 mL).


1957 ◽  
Vol 35 (12) ◽  
pp. 1522-1533 ◽  
Author(s):  
E. P. Swan ◽  
C. B. Purves

Cellulose sodium xanthates of degree of substitution (D.S.) 0.4 to 0.66 were methylated to xanthate S-methyl esters which were then acetylated completely, the final xanthate D.S. remaining close to the original value. Dexanthation with aqueous chlorine dioxide near pH 4.5 and −5° removed almost all of the S-methyl xanthate groups, but the loss of a few acetyl groups from, and the retention of 1 to 2% of sulphur in, the resulting cellulose acetate could not be avoided. The original xanthate groups were presumably represented in this acetate as unsubstituted hydroxyl groups, and these were located by standard methods involving tosylation–iodination, tritylation, and oxidations with lead tetraacetate. Xanthate groups appeared to occupy the third and sixth, but not the second, position in the cellulose, and 53 to 61% of the substituent was in the sixth or primary position; one sample of viscose was "ripened" before the cellulose sodium xanthate was isolated, and the value was 81%. The results were of a preliminary nature, because severe technical difficulties reduced their reliability.


Transfusion ◽  
2018 ◽  
Vol 59 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Caroline Sut ◽  
Sofiane Tariket ◽  
Chaker Aloui ◽  
Charles‐Antoine Arthaud ◽  
Marie‐Ange Eyraud ◽  
...  

2022 ◽  
pp. 1184-1202
Author(s):  
Anamika Basu ◽  
Anasua Sarkar ◽  
Piyali Basak

An allergy is an overreaction of the immune system to a substance called an antigen, e.g., pollen from grasses, dust mites, etc. The drugs used for allergy in allopathy have undesirable side effects. The use of medicinal plants becomes popular due to the adverse effects of allopathic drugs. Nutraceuticals are food playing a significant role in maintaining normal physiological function. Mast cells are immunologically important cells found in almost all parts of our body, and contain histamines, leukotrienes within their granular sacs, along with those of basophils, are responsible for the symptoms of allergy. According to sources mast cell stabilizers can be classified into three categories, e.g., synthetic, semi synthetic and natural. Mast cell stabilising agents from natural resources can be obtained from different group of compounds, e.g., flavonoids, coumarins, phenols, terpenoids, alkaloids. In this book chapter, the active constituents present in them and their mode of action are highlighted using techniques of computational biology, e.g., molecular docking, etc.


Blood ◽  
1983 ◽  
Vol 62 (2) ◽  
pp. 473-479 ◽  
Author(s):  
J Gmur ◽  
A von Felten ◽  
B Osterwalder ◽  
H Honegger ◽  
A Hormann ◽  
...  

Abstract A randomized study was performed in 54 thrombocytopenic patients with acute leukemia. Alloimmunization of recipients of random multiple-donor platelet concentrates (MD group) was compared to that of patients receiving random single-donor platelets (SD group). In the SD patients, formation of alloantibodies (mostly anti-HLA) occurred less frequently (p less than 0.002), after a longer time period (p less than 0.002), and after a higher number of transfusions (p less than 0.005) as compared to MD patients. SD patients also became refractory to random platelets less frequently (p less than 0.005), after a longer time period, and after a higher number of transfusions (p less than 0.02). In SD patients, the increments after the first and the last transfusion were in the same range, whereas in MD patients, the 1-hr (p less than 0.001) and the 24-hr (p less than 0.025) increments decreased from the first to the last transfusion. Thus, the use of random SD platelet transfusions postponed alloimmunization.


2019 ◽  
Vol 32 (1) ◽  
pp. 54-56
Author(s):  
Fredrik Hieronymus ◽  
Alexander Lisinski ◽  
Jakob Näslund ◽  
Elias Eriksson

AbstractIn two previous letters on an selective serotonin reuptake inhibitor (SSRI) meta-analysis conducted by the Copenhagen Trial Unit at Copenhagen University Hospital, we have commented on a large number of errors, almost all of which have tilted the results in an anti-drug direction, that unfortunately mar this publication. While the authors have acknowledged many of these mishaps, and may now be expected to submit an extensive errata list to the journal where their paper was once published, we regretfully note that also their latest contribution to this exchange is surprisingly inaccurate. However, its many shortcomings notwithstanding, their meta-analysis does add to the current literature by confirming that SSRIs do not seem to enhance the risk for suicide or death, and also that these drugs seem to enhance the risk of side effects categorised as serious only in the elderly.


2020 ◽  
Vol 47 (4) ◽  
pp. 314-325
Author(s):  
Sarah Anna Fiedler ◽  
Klaus Boller ◽  
Ann-Christine Junker ◽  
Christel Kamp ◽  
Anneliese Hilger ◽  
...  

Background: Platelet concentrates play an important role in transfusion medicine. Their short lifespan and lack of robustness require efforts to ensure adequate product quality. In this study, we compared the in vitro quality of the main concentrate types, pooled platelet concentrate (PPC) from whole blood donations, and platelet concentrate from single-donor apheresis (APC). Methods: Twenty PPCs and 20 APCs prepared in plasma were analyzed on days 2, 4, and 7 of storage. Variables related to metabolism, degranulation, platelet aggregation, P-selectin expression, and annexin V binding were analyzed. Morphology was assessed by transmission electron microscopy of ultrathin sections. A microfluidic device was applied to test the effects of shear stress on platelet function. Results: The metabolic parameters indicated stable storage conditions throughout the 7-day period. The resting discoid form was the prevailing morphology on days 2 and 4 in the PPCs and APCs. Chemokine release and receptor shedding of soluble P-selectin and soluble CD40L equally increased in PPCs and APCs. Aggregation responses to ADP and collagen were heterogeneous, with marked losses in collagen responsiveness on day 4 in individual concentrates. Baseline expression of P-selectin in PPCs and APCs was low, and inducibility of P-selectin was well preserved until day 4. Under shear stress, equal adhesiveness and stability were found with platelets from PPCs and APCs. Conclusions: Platelets from PPCs and APCs showed similar in vitro function and stability parameters. However, platelet concentrates presented a high variability and individual concentrates an impaired functional capability. Identifying the factors contributing to this would help increase product reliability.


2005 ◽  
Vol 23 (32) ◽  
pp. 8212-8218 ◽  
Author(s):  
Manish S. Bhandari ◽  
Juanita Crook ◽  
Maha Hussain

For several decades, androgen deprivation (AD) has been the mainstay for treating metastatic prostate cancer. AD can be attained by a variety of means; however, irrespective of modality and a gratifying initial high response rate, almost all patients advance to a state of androgen independence and ultimately a hormone-refractory state. Improved understanding of the biology and mechanisms of progression to androgen independence coupled with promising preclinical data have led to investigating intermittent AD (IAD) as a way of improving disease control while maintaining quality of life. Preliminary published clinical experience, mostly from uncontrolled trials, suggests the feasibility of this approach. Two ongoing cooperative-group phase III trials are evaluating the survival impact of IAD both in patients with metastatic disease and in those with prostate-specific antigen failure post–radiation therapy. There are several unanswered questions regarding this approach, and until more definitive data regarding its safety and impact on survival are available, IAD should be considered experimental. In this review, we detail the background and preclinical scientific rational for investigating IAD, and we review published clinical experience and describe the ongoing phase III clinical trials. We also discuss special considerations for using IAD outside the context of a clinical trial.


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