ABO-incompatible marrow transplants

Seventeen patients with aplastic anemia or acute leukemia received transplants from donors who had major ABO incompatibilities. Antibody titers were decreased by plasma and whole blood exchanges prior to marrow infusion. All 17 patients were successfully engrafted, and there was one possible rejection in the patient with the highest pretransplant anti-A IgG titer. Nine of 17 patients are currently alive. A review was carried out of transplants performed in Seattle between HLA-matched siblings with aplastic anemia and leukemia. Two hundred forty-six evaluable patients with ABO-compatible donors were compared with 46 with minor ABO-incompatible donors. There was no effect of minor ABO incompatibility on graft rejection, incidence and severity of graft-versus-host disease, or survival.

Competency assurance: applying the concept

The purpose of this paper is to increase understanding of the concept of competency assurance; to encourage associations of health professionals to develop a competency assurance program; and to motivate health care personnel to participate in a competency assurance program. The concept of competency assurance as defined by Wilson is used and its application and usefulness for a national association and its members are illustrated.

Questionnaire typography and production

This article describes the typographic principles and practice which provide the basis of good design and print, the relevant printing processes which can be used, and the graphic designer's function in questionnaire production. As they impose constraints on design decisions to be discussed later in the text, the various methods of printing and production are discussed first.

Phytohaemagglutinin-induced lymphocyte transformation in patients before and after resection of large intestinal cancer

Lymphocyte responses to stimulation with phytohaemagglutinin (PHA) have been compared in 20 patients with large intestinal cancer, 10 patients whose large intestinal cancers have been removed, and in 30 age- and sex-matched control individuals. Responses were markedly reduced in the tumour-bearing patients and were unaffected by substituting normal for autologous plasma during incubation. Responses, however, were normal after tumour resection suggesting that the defect in lymphocyte responsiveness is a reversible one and related to the presence of tumour tissue.