Transfusion最新文献

{"title":"Impact of cellular composition and T-cell senescence of mononuclear cell concentrates on the manufacturing process of chimeric antigen receptor (CAR) T-cells.","authors":"Vladan Vučinić, Theresa Tumewu, Mandy Brückner, Janine Kirchberg, Madlen Jentzsch, Raymund Buhmann, Yvonne Remane, Sandra Hoffmann, Florian Ramdohr, Maximilian Merz, Klaus H Metzeler, Sebastian Schwind, Carmen Herling, Simon M Krauß, Marco Herling, Georg-Nikolaus Franke, Nora Grieb, Georg Stachel, Martin Janz, Olaf Penack, Lars Bullinger, Ulrich Keller, Michael Cross, Reinhard Henschler, Enrica Bach, Uwe Platzbecker","doi":"10.1111/trf.18354","DOIUrl":"https://doi.org/10.1111/trf.18354","url":null,"abstract":"<p><strong>Background: </strong>Apheresis procedure of autologous lymphocytes competent for proliferation and expansion is a crucial step in the production of chimeric antigen receptor (CAR) T-cells. Previous therapies or disease status prior to collection may negatively impact the collections.</p><p><strong>Study design and methods: </strong>We performed a retrospective analysis with the aim to determine cellular factors in association with the collection of autologous T-cells and subsequent CAR T manufacturing toward tisagenlecleucel (tisa-cel). Between February 2019 and February 2022, 63 collections of 54 patients were performed for subsequent therapy with tisa-cel.</p><p><strong>Results: </strong>We observed no difference in median CD3+ cell yields according to the number of prior therapy lines (>3 vs. ≤3, p = .335), prior treatment with bendamustine (p = .954) or marrow infiltration (p = .634). Fifty-six collections were sent for manufacturing, of which 22 (39%) resulted in manufacturing failures, namely terminations (n = 12) or out-of-specification events (n = 10). Collections resulting in manufacturing failures yielded significantly lower CD3+ (p = .005), CD3+CD4+ (p = .044), and non-senescent CD3+CD27+CD28+ (p = .003) counts. Multivariable analysis identified the absolute number of CD3+CD27+CD28+ cells as relevant, with a calculated cut-off of ≥34.58 × 10⁸ CD3+CD27+CD28+ cells for 89.5% probability of successful CAR T-cell production.</p><p><strong>Discussion: </strong>In summary, we report a positive influence of a higher number of non-senescent Τ-cells on successful manufacturing. Further analyses are required to determine measures for further optimization of collection outcomes.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary prehospital Emergency Medical Services in the United States: An overview and considerations for the Transfusion Medicine Community.","authors":"Matthew J Levy, Pampee P Young, Emily Coberly, John B Holcomb, Francis X Guyette, Randall M Schaefer, Jon R Krohmer","doi":"10.1111/trf.18348","DOIUrl":"https://doi.org/10.1111/trf.18348","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying trauma patients who benefit from whole blood transfusion: An effect decomposition analysis on patient survival.","authors":"Crisanto M Torres, Allan E Stolarski, Kelly M Kenzik, Dane R Scantling, Aaron Richman, Noelle N Saillant, Joseph V Sakran","doi":"10.1111/trf.18346","DOIUrl":"https://doi.org/10.1111/trf.18346","url":null,"abstract":"<p><strong>Background: </strong>Although whole blood (WB) transfusion has gained attention as a potentially superior alternative to component therapy (CT) for patients experiencing severe traumatic hemorrhage, conflicting evidence leaves its optimal use unclear.</p><p><strong>Methods: </strong>We conducted a retrospective review of adult trauma patients treated at civilian trauma centers participating in Trauma Quality Improvement Program (TQIP) from 2020 to 2021. All received either WB or CT within four hours of emergency department arrival. We assessed the effect of WB versus CT by examining key clinical parameters and performing an effect decomposition analysis.</p><p><strong>Results: </strong>Of 34,476 patients, 9023 (29%) received WB, while 25,453 (71%) received CT alone. Across the entire cohort, there was no statistically significant difference in adjusted odds of 24-h mortality (aOR 0.85 [95% confidence interval (CI) 0.73-1.01], p = .052). However, patients presenting with hypotension showed lower unadjusted and adjusted odds of death when given WB, including those with systolic blood pressure (SBP) below 90 mmHg (aOR 0.72 [95% CI 0.55-0.96], p = .02) and 70 mmHg (aOR 0.64 [95% CI 0.45-0.91], p = .01).</p><p><strong>Discussion: </strong>These findings suggest that the effectiveness of whole blood (WB) is influenced by several clinical characteristics. Arrival hypotension appears to play a key role, accounting for 13% of the mortality difference observed with WB versus CT. Future prospective trials are needed to define optimal patient selection and identify those most likely to benefit from WB in trauma resuscitation.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and timing of seroconversion during pregnancy-A retrospective study to enable safe transfusion.","authors":"E Dreyfuss, V Yahalom, Y Barer, I Ambar, A Pardo, A Shmueli, O Houri, E Hadar, S Barbash-Hazan","doi":"10.1111/trf.18356","DOIUrl":"https://doi.org/10.1111/trf.18356","url":null,"abstract":"<p><strong>Background: </strong>During pregnancy, exposure to fetal red blood cell antigens can trigger alloimmunization. To enable safe transfusion of compatible blood for pregnant individuals where urgent surgery might be necessary, blood bank standards mandate a valid blood type and antibody screening every 72 h (\"3-day rule\"). This practice requires frequent blood drawings contributing to patient discomfort and costs. To investigate if this practice is required, we evaluated the proportion of pregnant individuals who develop clinically significant alloantibodies within 72 h of a previous negative antibody screen.</p><p><strong>Study design and methods: </strong>Retrospective cohort of RhD-positive pregnant individuals with initial negative antibody screens, undergoing repeated screens at variable intervals. Seroconversion rates were compared with healthy male blood donors. Characteristics of pregnant individuals with and without seroconversion were analyzed.</p><p><strong>Results: </strong>Among 8659 RhD-positive pregnant individuals with initial negative antibody screens, 56 (0.6%) converted to a positive antibody screen, while only 15 (0.2%) developed clinically significant alloantibodies. Of these 15, only one converted within 3 days of testing, while others converted within 5-95 days. Two of the 15 women received a blood transfusion, 8-97 days before seroconversion. No male donors seroconverted during 9 months of follow up. Pregnant individuals with seroconversion were more likely to have systemic lupus erythematosus and antiphospholipid antibody syndrome.</p><p><strong>Discussion: </strong>Only one pregnant individual developed clinically significant alloantibodies within 72 h of a negative screening, compared to none of the control group. For pregnant individuals without recent transfusion, extending antibody screening intervals to 1 week appears safe.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel method for autologous peripheral blood stem cell harvest using highly concentrated sodium citrate solution replacing acid citrate dextrose solution A.","authors":"Wataru Kitamura, Keiko Fujii, Masaya Abe, Kazuhiro Ikeuchi, Joji Shimono, Kana Washio, Fumio Otsuka, Yoshinobu Maeda, Nobuharu Fujii","doi":"10.1111/trf.18360","DOIUrl":"https://doi.org/10.1111/trf.18360","url":null,"abstract":"<p><strong>Background: </strong>As the processed blood volume increases, a larger amount of anticoagulant (AC) is required, which leads to a serious issue of fluid dilution in large-volume leukocytapheresis (defined as ≥3-fold total blood volume). We previously reported a novel method for allogeneic peripheral blood stem cell harvest (PBSCH) using highly concentrated sodium citrate (HSC; 5.32%), which shortened the procedure time and reduced the need for an AC solution without heparin. In this study, we extended this novel method to autologous PBSCH (auto-PBSCH) and compared it with patients who received auto-PBSCH using normal concentrated sodium citrate (NSC; 2.2%).</p><p><strong>Study design and methods: </strong>We retrospectively analyzed consecutive auto-PBSCH data obtained using the Spectra Optia continuous mononuclear cell collection mode between May 2017 and May 2025 at our institution.</p><p><strong>Results: </strong>Leukocytapheresis was performed using NSC in 36 patients and HSC in 22. In the HSC group, patients tended to be younger, had significantly lower body weight, and had significantly fewer hematopoietic tumors as primary diseases compared to the NSC group. After propensity score-matched cohort adjusted for patient background, the total amount of AC solution was significantly lower (694 [range, 77-1648] vs. 298 mL [range, 64-797], p = .02), and procedure time was significantly shorter (224 [range, 117-395] vs. 181 min [range, 103-309], p = .048) in the HSC group. Furthermore, the loss rates of magnesium and potassium were lower in the HSC group.</p><p><strong>Conclusion: </strong>This novel leukocytapheresis method demonstrated the efficacy and safety in auto-PBSCH, while minimizing the patient burden.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing hepatitis B virus infectivity in blood components following pathogen reduction using a human hepatocyte model.","authors":"Bryan J Visser, Santanu Biswas, Rana Eltahan, Rafaelle Fares-Gusmao, Subramanian Yegneswaran, Nina Mufti, Carlos H Villa, David R McGivern","doi":"10.1111/trf.18357","DOIUrl":"https://doi.org/10.1111/trf.18357","url":null,"abstract":"<p><strong>Background: </strong>Pathogen reduction technologies (PRTs) have the potential to reduce the risk of emerging transfusion transmissible infections. Evaluating PRT activity against hepatitis B virus (HBV) presents some unique challenges due to the lack of robust model systems. Surrogate viruses (e.g., duck HBV) can be used, but may differ from the human pathogen in ways that influence susceptibility to a given PRT.</p><p><strong>Methods: </strong>Whole blood (WB) collected from volunteers was spiked with human plasma from deferred HBV-positive donors. Spiked WB was then treated with the nucleic acid crosslinking compound S-303 or left untreated. Additional physical and chemical treatments were also assessed. Plasma prepared from the spiked WB was used to inoculate human hepatocyte cultures isolated from chimeric mice with humanized livers. Culture medium was monitored over time for hepatitis B surface antigen (HBsAg) and viral DNA. Cell lysates were analyzed for evidence of covalently closed circular (ccc) DNA.</p><p><strong>Results: </strong>The culture system faithfully measured infectious HBV in blood components. S-303 treatment of HBV-spiked WB prevented infection of hepatocyte cultures, as monitored by HBsAg expression, at concentrations as low as 0.125 mM of S-303 or with incubation times as short as 1 h. Additionally, S-303 treatment prevented the accumulation of T5 exonuclease-resistant HBV DNA in inoculated hepatocytes, suggesting that S-303 prevents establishment of HBV cccDNA.</p><p><strong>Conclusion: </strong>This model mimics transfusion transmission by using donor-derived HBV and mouse-passaged human hepatocytes, allowing evaluation of the efficacy of different PRTs against authentic human HBV isolates. We found S-303 to be a potent inactivator of HBV.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare case of warm IgM autoimmune hemolytic anemia.","authors":"Bryan Tordon, Nour Alhomsi, Ali Iqbal, Azim Gangji, Gwen Clarke, Shuoyan Ning","doi":"10.1111/trf.18353","DOIUrl":"https://doi.org/10.1111/trf.18353","url":null,"abstract":"<p><p>Cold agglutinins are IgM-mediated autoimmune hemolytic processes that most often cause destruction of red blood cells at colder temperatures. Here we describe a case of a patient with history of living donor renal transplantation that developed an atypical autoantibody causing profound anemia and hemolysis which, although IgM in nature, reacted best at warmer temperatures and was caused by a lymphoproliferative disorder. The investigations and serological findings here raise awareness to less common forms of autoimmune hemolytic disorders and describe specialized tests that can help uncover these antibodies. This case also highlights a rare presentation of post-transplant lymphoproliferative disorder manifesting clinically as hemolytic anemia.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood deserts in a universal health system: Addressing structural inequities in northern Canada.","authors":"Boaz Laor, Shreenik Kundu","doi":"10.1111/trf.18347","DOIUrl":"https://doi.org/10.1111/trf.18347","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-dependent overestimation of IgM antibody titers by IgG in the column agglutination technique.","authors":"Hayato Kojima, Hideaki Matsuura, Yuko Abe, Ayuna Yamada, Yasuo Miura","doi":"10.1111/trf.18340","DOIUrl":"https://doi.org/10.1111/trf.18340","url":null,"abstract":"","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of peripheral blood stem cell collection in children with extremely low body weight: A single center study.","authors":"S Grewal, R Hassanein, S Mendoza, E Sajdak, H C Sullivan, R Jacob","doi":"10.1111/trf.18345","DOIUrl":"https://doi.org/10.1111/trf.18345","url":null,"abstract":"<p><strong>Background: </strong>Apheresis cell collections (HPC(A)) are used for hematopoietic stem cell transplantation and gene therapy; however, they present unique challenges in children with extremely low body weight (≤10 kg). We aimed to investigate the feasibility and safety of HPC(A) in these patients.</p><p><strong>Study design and methods: </strong>This retrospective single-center study reviewed HPC(A) collections at one pediatric center between 2017 and 2024 in patients ≤10 kg. Data included collection parameters, anticoagulant type, and demographics. Feasibility was assessed on target CD34+ count. Safety was evaluated on the incidence and severity of adverse events (AEs). Descriptive statistics and comparative tests (Wilcoxon rank sum, Welch t-test) were applied.</p><p><strong>Results: </strong>Nineteen patients underwent 20 autologous collections with an average patient weight of 7.70 kg. Central venous access was required in all, with 90% inpatient collections. Average patient total blood volume and volume processed were 557 and 2523 mL. Collections used acid citrate dextrose, solution A (ACD-A) only (50%) or ACD-A + heparin (50%). Run times between the two were not significantly different, but the inlet flow rate was significantly higher in the ACD-A + heparin group (p = .017). 90% of patients received granulocyte colony-stimulating factor only, with the remainder also receiving plerixafor. Average minimum-target dose was 12.8-20.5 million CD34/kg. The target dose was achieved on Day 1 of collection in 19 collections (95%), with the target achieved on Day 2 in the single remaining patient. There was one incidence of hypocalcemia with no serious AEs. Average collection efficiency (CE)1 and CE2 were 59% and 49%.</p><p><strong>Discussion: </strong>HPC(A) is feasible and safe in patients ≤10 kg, including with ACD-A + heparin anticoagulation, supporting broader application in this population.</p>","PeriodicalId":23266,"journal":{"name":"Transfusion","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}