Journal of hematotherapy最新文献

{"title":"Evaluation of mobilized CD34+ cell counts to guide timing and yield of large-scale collection by leukapheresis.","authors":"L M Knudsen,&nbsp;E Gaarsdal,&nbsp;L Jensen,&nbsp;K Nikolaisen,&nbsp;H E Johnsen","doi":"10.1089/scd.1.1998.7.45","DOIUrl":"https://doi.org/10.1089/scd.1.1998.7.45","url":null,"abstract":"<p><p>We have previously reported a more than 50% risk of insufficient harvests (< 2 x 10(6) CD34+ cells/kg) following a fixed timing of leukapheresis in an unselected patient population collected for autologous stem cell transplantation. The failures were easily identified as patients who had < 20,000/ml CD34+ blood cells at the time of harvest. Consequently, in an attempt to optimize the timing strategy, we decided to perform daily analysis of the blood levels and perform leukapheresis within 24 h after the blood cell count exceeded 20,000 CD34+/ml. The results of this prospective study showed (a) that leukapheresis collections that were initiated based on the CD34+ blood level resulted in a success rate of 85% following 1-3 day harvests, (b) that high-level mobilizers with > 80,000 CD34+ cells/ml can be harvested successfully by only one procedure, and (c) that low-level mobilizers with < 40,000 CD34+ cells/ml still have a high risk of inadequate harvests. In summary, the optimized timing strategy is effective, but there is still room for improvement. First, new potent priming procedures for low-level and bad mobilizers are required, and second, algorithms to reduce the leukapheresis volume and time for high-level mobilizers should be established.</p>","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"7 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1998.7.45","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20430861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of interface/offset (I/O) adjustment on collection efficiency using the Fenwal CS3000 Plus Blood Cell Separator for peripheral blood progenitor cell collection.","authors":"R A Preti,&nbsp;K M Zahos,&nbsp;A A Jennis,&nbsp;J Murawski,&nbsp;S Nadasi,&nbsp;L Doria,&nbsp;R E Isaacs,&nbsp;J A Brochstein,&nbsp;A L Pecora","doi":"10.1089/scd.1.1998.7.53","DOIUrl":"https://doi.org/10.1089/scd.1.1998.7.53","url":null,"abstract":"<p><p>Peripheral blood progenitor cells (PBPC) reside within the mononuclear cell (MNC) component of the blood and can be collected using a number of apheresis devices, including the Fenwal CS3000 Plus Blood Cell Separator. Increased MNC collection efficiency, therefore, may reduce the number of apheresis required to achieve collection goals. In this study, patients were divided into groups by absolute MNC count to determine the effect of interface detector offset (I/O) adjustment on MNC collection efficiency. Apheresis products from 104 procedures collected using a standard I/O setting of 100 were compared with 121 collections for which the I/O setting was adjusted according to the preapheresis MNC count. Adjustment of the I/O setting in this manner had no statistically significant impact on the per kilogram dose of MNC collected. The data did show that MNC collection efficiency was reduced as both the MNC count and I/O setting increased, as the collection efficiency was greatest for patients with the lowest peripheral MNC counts and was inversely correlated with the preapheresis MNC count. Although contamination of the product with platelets was drastically reduced at higher I/O settings, there was a concomitant rise in RBC contamination. We conclude that a standard setting of 100 is preferable to adjustment of the I/O setting as a function of the preapheresis MNC count.</p>","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"7 1","pages":"53-61"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1998.7.53","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20430862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a quality system (ISO 9000 series) for placental blood banking.","authors":"G Sirchia,&nbsp;P Rebulla,&nbsp;L Lecchi,&nbsp;F Mozzi,&nbsp;R Crepaldi,&nbsp;A Parravicini","doi":"10.1089/scd.1.1998.7.19","DOIUrl":"https://doi.org/10.1089/scd.1.1998.7.19","url":null,"abstract":"<p><p>Although placental blood has recently become a new source of hematopoietic progenitors for marrow replacement, limited attention has been given to systems suitable to ensure the short-term and long-term quality of placental blood units used for transplantation. In this article, we describe a quality system for placental blood banking developed in accord with ISO 9002 norms at Milano Cord Blood Bank. The quality system is the organizational structure, procedures, processes, and resources needed to implement quality management. ISO 9002 is a model for quality assurance in production, installation, and servicing, which includes a number of clauses providing guidance for the implementation of the quality system. The quality system was started by the bank medical director with step 1: the general quality plan, which included (a) the written description of mission, objectives, technical and organizational policies, and staff organization chart of the placental blood bank, (b) the definition and acquisition of adequate financial, human, and structural resources, (c) the appointment of a quality system head independent from the production laboratory and reporting directly to the medical director. Tasks of the quality system head were (a) to identify the placental blood banking process together with the placental blood bank personnel, (b) to implement a documentation plan finalized at the production and maintenance of (i) the quality manual, which provides a summary on how the bank operates with a quality system in compliance with the ISO 9002 clauses, (ii) the general procedures (or quality system procedures), which provide more detail on selected clauses, including at least those prescribed by the ISO 9002 standard, (iii) the operative procedures (or process procedures), which describe in detail the process of placental blood banking and how technical activities must be performed, (iv) the work instructions, which provide stepwise descriptions of individual activities, (v) records/forms for data collection and storage, (c) to identify quality indicators, (d) to start a regular internal audit, (e) to report audit results to the medical director for review. This was followed by step 2: the job descriptions, staff training, and qualification; step 3: the documentation plan; step 4: the internal audit plan; step 5: the launch of the quality system, and step 6: the assessment by an external team from an accredited third-party organization and final certification for compliance to ISO 9002. The quality system, which must be maintained and undergo external audit at regular intervals so that certification is confirmed, ensures the high probability that placental blood units provided to clinicians conform regularly to predefined levels of quality.</p>","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"7 1","pages":"19-35"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1998.7.19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20430859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The FAHCT of the matter.","authors":"R A Preti","doi":"10.1089/scd.1.1998.7.1","DOIUrl":"https://doi.org/10.1089/scd.1.1998.7.1","url":null,"abstract":"","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1998.7.1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20432443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral blood progenitor cell collection by large-volume leukapheresis in low-weight children.","authors":"M A Diaz,&nbsp;A Alegre,&nbsp;A Benito,&nbsp;M Villa,&nbsp;L Madero","doi":"10.1089/scd.1.1998.7.63","DOIUrl":"https://doi.org/10.1089/scd.1.1998.7.63","url":null,"abstract":"<p><p>Large-volume leukapheresis (LVL), defined as the processing of at least three blood volumes in a single session for peripheral blood progenitor cell (PBPC) collection, was performed in 32 small children weighing < or = 25 kg, aged 10 months to 8 years, with a variety of malignancies. Harvesting of PBPC was started after 4 days of cytokine (G-CSF, 12 micrograms/kg s.c.) alone. Procedures were performed using a continuous flow blood cell separator (COBE Spectra). The automated program of lymphocytapheresis was modified to achieve a collection rate of 0.9 ml/min. The extracorporeal line was primed with a unit of a packed red blood cells before the procedure. Acid citrate dextrose (ACD) was used as anticoagulant with an ACD inlet ratio of 1:14 and an ACD infusion rate of 1.1 ml/min/L of total blood volume. The inlet flow ranged between 6 and 35 ml/min (median 20 ml/min). A total of 37 apheresis procedures were performed (median 1, range 1-3). In 84% of patients, a single apheresis yields the minimum number of PBPC cells required for transplantation. No consistent side effects were observed, and LVL was well tolerated by children. A median of 7.7 x 10(8) kg MNC, 5.4 x 10(6)/kg CD34+, and 6.2 x 10(4)/kg CFU-GM per apheresis were harvested. Patients with neuroblastoma had a significantly lower yield than other patients. To date, 27 patients have been transplanted after myeloablative treatment, and rapid and sustained engraftment was achieved in all cases. The number of CD34+ cells infused was highly correlated with engraftment kinetics. LVL can be safely and easily performed in small children, allowing adequate PBPC collection for transplantation with rapid hematologic recovery.</p>","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"7 1","pages":"63-8"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1998.7.63","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20430863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered sensitivities to anticancer and differentiation agents in etoposide-resistant human myeloid leukemia U-937 cells.","authors":"P Pantazis,&nbsp;A DeJesus,&nbsp;J Early,&nbsp;B Giovanella","doi":"10.1089/scd.1.1998.7.81","DOIUrl":"https://doi.org/10.1089/scd.1.1998.7.81","url":null,"abstract":"<p><p>We previously have exposed U-937 human leukemia cells to stepwise increased concentrations of the anticancer drug etoposide, and this treatment has resulted in stable sublines (termed U-937/RE) exhibiting various extents of resistance to the drug and constitutively expressing c-fms mRNA, a specific marker of monocytic differentiation. In this report, we pursued studies to show that the P-glycoprotein blocker, verapamil, partially restores sensitivity to etoposide in U-937/RE cells. Further, the U-937/RE cells exhibit differential sensitivities to compounds that induce maturation of U-937 cells, as judged by the ability to reduce nitroblue tetrazolium and by morphologic changes, and increased sensitivities to apoptosis induction by the cytokines tumor necrosis factor (TNF) and lymphotoxin (LT) and the anticancer drugs 9-nitrocamptothecin and doxorubicin. In addition, the U-937/RE cells, xenografted in immunodeficient mice, demonstrate decreased or no ability to induce tumors. Taken together, these findings indicate that U-937/RE cells differ from the parental U-937 cells in several functional properties and can serve as models to develop protocols for treatment of human leukemia.</p>","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"7 1","pages":"81-92"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1998.7.81","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20430865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimal residual disease in solid tumor malignancies: a review.","authors":"A A Ross","doi":"10.1089/scd.1.1998.7.9","DOIUrl":"https://doi.org/10.1089/scd.1.1998.7.9","url":null,"abstract":"<p><p>The increase in the number of patients treated with high-dose chemotherapy/autologous stem cell transplantation (HDC/ASCT) for solid tumor malignancies has generated concern about the infusion of tumor cell contamination in the graft. In an effort to study so-called minimal residual disease (MRD) in the HDC/ASCT setting, a variety of assay methods have been used. Although these assays vary in terms of sensitivity and specificity of tumor detection, they are in agreement as to the presence and viability of tumor cells in ASCT grafts. A growing body of evidence indicates that MRD is present in ASCT grafts from neuroblastoma, breast cancer, and ovarian cancer patients. More importantly, several retrospective studies have determined that the infusion of tumor cells with the ASCT graft is strongly associated with post-ASCT relapse. Gene-marking studies have directly demonstrated that infused tumor cells are present at sites of disease relapse. Thus, the issue of tumor contamination of autologous grafts is an area of growing concern. This review article details the current status of MRD in solid tumor malignancies, with emphasis on assay methodology, clinical utility, and clinical relevance in transplantation medicine.</p>","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"7 1","pages":"9-18"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1998.7.9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20432446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD34 enumeration.","authors":"A L Pecora,&nbsp;R S Negrin","doi":"10.1089/scd.1.1998.7.3","DOIUrl":"https://doi.org/10.1089/scd.1.1998.7.3","url":null,"abstract":"","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"7 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"1998-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1998.7.3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20432444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of molecular cytokeratin 19 reverse transcriptase polymerase chain reaction (CK19 RT-PCR) and immunocytochemical detection of micrometastatic breast cancer cells in hematopoietic harvests.","authors":"M D Traystman,&nbsp;G T Cochran,&nbsp;S J Hake,&nbsp;C A Kuszynski,&nbsp;S L Mann,&nbsp;B J Murphy,&nbsp;S J Pirruccello,&nbsp;E Zuvanich,&nbsp;J G Sharp","doi":"10.1089/scd.1.1997.6.551","DOIUrl":"https://doi.org/10.1089/scd.1.1997.6.551","url":null,"abstract":"<p><p>Detection of small numbers of breast cancer cells in patient blood, aphereses, and bone marrow has become increasingly important as data have accumulated showing immunocytochemically (ICC) positive tumor cells in up to 50% of women with stage I and II breast cancer, who were initially thought to be cured of their disease but later relapsed. The ability to rule out the presence of micrometastatic disease at any stage of the clinical management protocol, whether before, during, or after therapy, would provide a useful monitoring and diagnostic tool for both the clinician and the scientist. Monitoring for the presence of minimal residual disease (MRD) is traditionally performed using ICC. A more recently established RT-PCR technique uses a molecular marker (the presence of the cytokeratin 19, CK19, transcript) to identify MRD in patient samples, with a level of sensitivity reported to be one tumor cell in 10(6) nucleated cells. This level of sensitivity is generally higher than that claimed for ICC. Based on the discriminating results of this first study, a number of laboratories have evaluated this technique for its diagnostic potential. Results from several laboratories showed a higher than expected false positive rate due to a variety of identified and unidentified sources. Therefore, the current study was designed to achieve two aims: to establish the level of sensitivity and specificity of the RT-PCR technique and to dissect out the possible variables that may contribute to a false positive result using this molecular approach. To accomplish the first goal, two simulation strategies were used, limited dilution of tumor cells into apheresis harvests and semi-quantitative PCR using stepwise dilutions of extracted RNA from tumor cells in apheresis harvests. The second goal was accomplished by performing sequential blood drawings with variably timed sample processing to identify some of the more common variables (time, anticoagulant, sample sequence) that may contribute to false positive results. Of three variables investigated, including type of blood preservative, sequence of blood tube collection, and time point of sample processing, each may contribute to a false positive result. In addition to these problems, known events involving illegitimate transcription of specific genes nonspecifically in tissue is also a potential source of false positive results. These issues may be further compounded by lack of attention to the more common methodologic problems encountered in any laboratory using the PCR technique. However, recommendations can be developed for the effective application of this technique, whose greatest strength is the demonstration of tumor negativity of the sample.</p>","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"6 6","pages":"551-61"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1997.6.551","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20408880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New York State guidelines for cord blood banking. Department of Health.","authors":"J V Linden,&nbsp;R A Preti,&nbsp;R Dracker","doi":"10.1089/scd.1.1997.6.535","DOIUrl":"https://doi.org/10.1089/scd.1.1997.6.535","url":null,"abstract":"<p><p>In response to the profound interest in the transplantation of umbilical cord blood, the New York State (NYS) Department of Health embarked on a regulatory strategy designed to provide guidance to the practitioner while allowing for the flexibility required by the inherent developmental nature of the technology. The result was the development of the Guidelines for Collection, Processing, and Storage of Cord Blood Stem Cells, adherence to which is optional. It is anticipated that through the use of such guidelines as a supplement to the existing hematopoietic progenitor cell (HPC) regulations for tissue banks, practitioners may provide to potential patients the safest and most efficacious cord blood products currently available, and information gained through the use of these products will be of optimal value toward the goal of continuous improvement in the delivery of this new technology.</p>","PeriodicalId":77208,"journal":{"name":"Journal of hematotherapy","volume":"6 6","pages":"535-41"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/scd.1.1997.6.535","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20408878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}