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Savioli ML, Sakashita AM, Cipolletta ANF, Brandão RCTDC, Kutner JM. Telemedicine pre-screening for blood donor. Hematol Transfus Cell Ther 2024:S2531-1379(24)00007-5. [PMID: 38307827 DOI: 10.1016/j.htct.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/16/2023] [Accepted: 11/09/2023] [Indexed: 02/04/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic had an important impact on blood bank services. The onset of the pandemic led to a decrease in the number of blood donors. A remote interview would avoid deferred donors from having to travel to the blood bank. We evaluate the feasibility of using telemedicine as an alternative to a face-to-face interview as a first blood donor screening. METHODS Our retrospective study included 404 whole blood and platelets donors, who underwent the clinical interview remotely via telemedicine. The deferred donor would not need to go to the blood bank and eligible candidates were required to donate within 7 days. On the day of donation, a mini-interview was held to ensure donor and blood safety. RESULTS The appointments were made from June 2020 to June 2022, including 263 candidates for whole blood (WB) and 141 for platelets (PLTs). At the end of the telemedicine interview, 285 (70.6 %) candidates were considered eligible. Telemedicine was not performed for 60 (14.8 %) candidates due to technical problems (with audio or video) or absences. The deferral rate among candidates who underwent telemedicine pre-screening was 14.6 % and, among eligible donors after telemedicine, only 7 (2.9 %) were unable to donate blood. CONCLUSION Telemedicine is a viable alternative and a welcome convenience for potential donors to avoid unnecessary travel.
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Cloutier M, Cognasse F, Yokoyama APH, Hazegh K, Mykhailova O, Brandon-Coatham M, Hamzeh-Cognasse H, Kutner JM, Acker JP, Kanias T. Quality assessment of red blood cell concentrates from blood donors at the extremes of the age spectrum: The BEST collaborative study. Transfusion 2023; 63:1506-1518. [PMID: 37387566 DOI: 10.1111/trf.17471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/07/2023] [Accepted: 06/04/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Blood donors at the extremes of the age spectrum (16-19 years vs. ≥75 years) are characterized by increased risks of iron deficiency and anemia, and are often underrepresented in studies evaluating the effects of donor characteristics on red blood cells (RBC) transfusion effectiveness. The aim of this study was to conduct quality assessments of RBC concentrates from these unique age groups. STUDY DESIGN We characterized 150 leukocyte-reduced (LR)-RBCs units from 75 teenage donors, who were matched by sex, and ethnicity with 75 older donors. LR-RBC units were manufactured at three large blood collection centers in the USA and Canada. Quality assessments included storage hemolysis, osmotic hemolysis, oxidative hemolysis, osmotic gradient ektacytometry, hematological indices, and RBC bioactivity. RESULTS RBC concentrates from teenage donors had smaller (9%) mean corpuscular volume and higher (5%) RBC concentration compared with older donors counterparts. Stored RBCs from teenage donors exhibited increased susceptibility to oxidative hemolysis (>2-fold) compared with RBCs from older donors. This was observed at all testing centers independent of sex, storage duration, or the type of additive solution. RBCs from teenage male donors had increased cytoplasmatic viscosity and lower hydration compared with older donor RBCs. Evaluations of RBC supernatant bioactivity suggested that donor age was not associated with altered expression of inflammatory markers (CD31, CD54, and IL-6) on endothelial cells. CONCLUSIONS The reported findings are likely intrinsic to RBCs and reflect age-specific changes in RBC antioxidant capacity and physical characteristics that may impact RBC survival during cold storage and after transfusion.
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Affiliation(s)
- Marc Cloutier
- Affaires Médicales et Innovation, Héma-Québec, Québec, Québec, Canada
| | - Fabrice Cognasse
- Research Department, F-42023, Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
- INSERM, U 1059 SAINBIOSE, Université Jean Monnet Saint-Étienne, Mines Saint Etienne, F-42023, Saint-Etienne, France
| | | | | | - Olga Mykhailova
- Innovation and Portfolio Management, Canadian Blood Services, Edmonton, Alberta, Canada
| | | | - Hind Hamzeh-Cognasse
- Research Department, F-42023, Établissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
- INSERM, U 1059 SAINBIOSE, Université Jean Monnet Saint-Étienne, Mines Saint Etienne, F-42023, Saint-Etienne, France
| | - Jose Mauro Kutner
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Jason P Acker
- Innovation and Portfolio Management, Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Tamir Kanias
- Vitalant Research Institute, Denver, Colorado, USA
- Department of Pathology, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA
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Yokoyama APH, Kutner JM, de Moraes Mazetto Fonseca B, Mesquita GLTV, Sakashita AM, Dos Santos APR, Nakazawa CY, de Almeida MD, de Andrade Orsi FL. Neutrophil extracellular traps (NETs), transfusion requirements and clinical outcomes in orthotopic liver transplantation. J Thromb Thrombolysis 2023:10.1007/s11239-023-02825-7. [PMID: 37227652 DOI: 10.1007/s11239-023-02825-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 05/26/2023]
Abstract
Inflammatory phenomena have a direct impact on the prognosis of orthotopic liver transplantation (OLT). Neutrophil extracellular traps (NETs) contribute to OLT inflammation and hemostasis imbalance in OLT. The association between NETosis, clinical outcomes and transfusion requirements is not determined. To evaluate NETs release during OLT and the effect of NETosis ontransfusion requirements and adverse outcomes in a prospective cohort of patients submitted to OLT. We quantified citrullinated histones (cit-H3) and circulating-free-DNA (cf-DNA) in ninety-three patients submitted to OLT in three periods: pre-transplant, after graft reperfusion and before discharge. NETs markers were compared between these periods using ANOVA test. The association of NETosis and adverse outcomes was evaluated using regression models adjusted for age, sex and corrected MELD. We observed a peak of circulating NETs following reperfusion, evidenced by a 2.4-fold increase in cit-H3 levels in the post-graft reperfusion period (median levels of cit-H3 pre transplant: 0.5 ng/mL, after reperfusion: 1.2 ng/mL and at discharge 0.5 ng/mL, p < 0.0001). We observed an association between increased levels of cit-H3 and in-hospital death (OR = 1.168, 95% CI 1.021-1.336, p = 0.024). No association was found between NETs markers and transfusion requirements. There is a prompt release of NETs after reperfusion that is associated with poorer outcomes and death. Intraoperative NETs release seems to be independent of transfusion requirements. These findings highlight the relevance of inflammation promoted by NETS and its impact on OLT adverse clinical outcomes.
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Affiliation(s)
- Ana Paula Hitomi Yokoyama
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Av Albert Einstein, 627-3o Andar, São Paulo, SP, 05652-000, Brazil.
- Faculty of Medical Sciences, University of Campinas, Campinas, Brazil.
| | - Jose Mauro Kutner
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Av Albert Einstein, 627-3o Andar, São Paulo, SP, 05652-000, Brazil
| | | | | | - Araci Massami Sakashita
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Av Albert Einstein, 627-3o Andar, São Paulo, SP, 05652-000, Brazil
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Kondo AT, Alvarez KCA, Cipolletta ANF, Sakashita AM, Kutner JM. Nucleated red blood cell: a feasible quality parameter of cord blood units. Hematol Transfus Cell Ther 2023:S2531-1379(23)00037-8. [PMID: 36935342 DOI: 10.1016/j.htct.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/20/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Umbilical cord blood is an alternative source of hematopoietic progenitor cells for bone marrow transplantation; however, it is associated with a higher graft failure rate. The presence of a high rate of nucleated red blood cells (NRBCs) seems to be related to a greater capacity for engraftment, although is also associated with fetal distress conditions. We analyzed the correlation of the NRBC with quality parameters and its association with the utilization score of a cord blood unit. STUDY DESIGN AND METHOD Data of 3346 units collected in a public cord blood bank from May 2010 to December 2017 were analyzed, retrospectively, to identify factors associated with an increased number of nucleated red blood cells and its correlation with the engraftment capacity measured through total nucleated cells (TNCs) and CD34 positive cells. We also evaluated the utilization score of these units and identified an NRBC cutoff associated with a higher score. RESULTS The median volume collected was 104 mL (42-255), the pre-processing TNC count was 144.77 × 107 (95.46-477.18), the post-processing TNC count was 119.44 × 107 (42.7-477.18), the CD34 count was 4.67 × 106 (0.31-48.01), the NRBC count was 5 (0-202) and the utilization score was 0.0228 (0.00143-0.9740). The NRBC showed a correlation with the collected volume, TNC and CD34 positive cells and a higher utilization score and the receiver operating characteristic (ROC) curve analysis identified the five NRBC/100 leukocytes cutoff that correlates better with the probability of use. No association with pathological conditions and the NRBC rate was observed. CONCLUSIONS The NRBC is a feasible parameter for the screening of the cord blood unit (CBU) and the minimum cutoff of five NRBC/100 leukocytes can be a strategy in conjunction with the TNC to identify better units for cord blood bank sustainability.
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Aravechia MG, Costa TH, Jesus HW, Santos LD, Pereira MB, Sirianni MF, Messias MDG, Bub CB, Kutner JM. A GE:-13 (GECT-) HETEROZIGOUS AND GE:-14 (GEAR) HOMOZIGOUS PHENOTYPE DETECTED BY RANDOM SCREENING FOR GE:-2 BLOOD DONORS IN BRAZIL. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Oliveira TC, Santos LD, Aravechia MG, Gomes I, Blanco BP, Sampaio TB, Carneiro JDA, Bub CB, Kutner JM. ANEMIA HEMOLÍTICA IMUNE INDUZIDA POR CEFTRIAXONA: RELATO DE CASO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Blanco BP, Santos LD, Oliveira TC, Sampaio TB, Santos IGE, Bub CB, Kutner JM. SÍNDROME DO LINFÓCITO PASSAGEIRO APÓS TRANSPLANTE HEPÁTICO: RELATO DE CASO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Dutra VF, Yokoyama APH, Bub CB, Dametto APF, Assunção MSC, Sakashita AM, Kutner JM. PERFIL CLÍNICO E LABORATORIAL DE PACIENTES QUE FIZERAM USO DE PLASMA CONVALESCENTE COMPASSIVO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Savioli ML, Santos LD, Franco AB, Myazi LYL, Pereira JK, Silva RME, Santos RBD, Aravechia MG, Kutner JM. TRIAGEM BACTERIANA DE PLAQUETAS EM UM SERVIÇO DE HEMOTERAPIA DE SÃO PAULO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Alves-Paiva RM, do Nascimento S, De Oliveira D, Coa L, Alvarez K, Hamerschlak N, Okamoto OK, Marti LC, Kondo AT, Kutner JM, Bortolini MAT, Castro R, de Godoy JAP. Senescence State in Mesenchymal Stem Cells at Low Passages: Implications in Clinical Use. Front Cell Dev Biol 2022; 10:858996. [PMID: 35445029 PMCID: PMC9015663 DOI: 10.3389/fcell.2022.858996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022] Open
Abstract
Mesenchymal stem cells (MSCs) are multipotent cells found in various tissues and are easily cultivated. For use in clinical protocols, MSCs must be expanded to obtain an adequate number of cells, but a senescence state may be instituted after some passages, reducing their replicative potential. In this study, we report a case where MSC derived from an elderly donor acquired a senescence state after three passages. The bone marrow was aspirated from a female patient submitted to a cell therapy for the incontinency urinary protocol; MSCs were cultivated with DMEM low glucose, supplemented with 10% autologous serum (AS) plus 1% L-glutamine and 1% antibiotic/antimycotic. Senescence analysis was performed by β-galactosidase staining after 24 and 48 h. Controls were established using BM-MSC from healthy donors and used for senescence and gene expression assays. Gene expression was performed using RT-PCR for pluripotency genes, such as SOX2, POU5F1, NANOG, and KLF4. MSC telomere length was measured by the Southern blotting technique, and MSCs were also analyzed for their capacity to differentiate into adipocytes, chondrocytes, and osteocytes. The patient’s MSC expansion using AS displayed an early senescence state. In order to understand the role of AS in senescence, MSCs were then submitted to two different culture conditions: 1) with AS or 2) with FBS supplementation. Senescence state was assessed after 24 h, and no statistical differences were observed between the two conditions. However, patients’ cells cultured with AS displayed a higher number of senescence cells than FBS medium after 48 h (p = 0.0018). Gene expression was performed in both conditions; increased expression of KLF4 was observed in the patient’s cells in comparison to healthy controls (p = 0.0016); reduced gene expression was observed for NANOG (p = 0.0016) and SOX2 (p = 0.0014) genes. Telomere length of the patient’s cells was shorter than that of a healthy donor and that of a patient of similar age. Osteocyte differentiation seemed to be more diffuse than that of the healthy donor and that of the patient of similar age. MSCs could enter a senescence state during expansion in early passages and can impact MSC quality for clinical applications, reducing their efficacy when administered.
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Affiliation(s)
- Raquel M Alves-Paiva
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Sabrina do Nascimento
- Experimental Research Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Denise De Oliveira
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Larissa Coa
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Kelen Alvarez
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Nelson Hamerschlak
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Oswaldo Keith Okamoto
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Human Genome and Stem Cell Research Center, Department of Genetics and Evolutionary Biology, Biosciences Institute, University of São Paulo (USP), Sao Paulo, Brazil
| | - Luciana C Marti
- Experimental Research Laboratory, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Andrea T Kondo
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Jose Mauro Kutner
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Rodrigo Castro
- Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Juliana A Preto de Godoy
- Department of Hemotherapy and Cellular Therapy, Hospital Israelita Albert Einstein, São Paulo, Brazil
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Ferraz Sallum JM, Godoy J, Kondo A, Kutner JM, Vasconcelos H, Maia A. The first gene therapy for RPE65 biallelic dystrophy with voretigene neparvovec-rzyl in Brazil. Ophthalmic Genet 2022; 43:550-554. [PMID: 35416119 DOI: 10.1080/13816810.2022.2053995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To report the first Brazilian patient with RPE65 deficiency-inherited retinal dystrophy (RPE65-IRD) treated with voretigene neparvovec-rzyl (VN). METHODS An adult patient with Leber congenital amaurosis-2 with a homozygous mutation in the RPE65 gene (p.Phe83Leu) was treated bilaterally with VN. The clinical and surgical aspects are described. The baseline and 4-month postoperative ophthalmologic examinations included measurement of the best-corrected visual acuity (BCVA), full-field stimulus threshold (FST) test, Octopus 900 semiautomated kinetic visual fields (VFs), and microperimetry. RESULTS No complications developed in this patient. The BCVA remained stable. The full-field stimulus threshold test (FST) and VFs showed clinically significant improvements bilaterally. The patient reported significant improvements in the ability to perform daily activities, mainly for those requiring the VFs and vision in a low-luminescence environment. CONCLUSIONS The treatments were beneficial for this patient who was homozygous for RPE65 p.Phe83Leu. The first VN treatments in an adult Brazilian patient in clinical practice showed measurable improvements in visual outcomes that were meaningful for the patient's daily activities. TRANSLATIONAL RELEVANCE This case reinforces the clinical trial results and proves that the procedure is feasible in countries such as Brazil.
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Affiliation(s)
| | - Juliana Godoy
- Blood Bank Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Andrea Kondo
- Blood Bank Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | - Andre Maia
- Federal University of São Paulo - UNIFESP, São Paulo, Brazil
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Waisbeck TM, Vogel C, Silva CC, Arcuri LJ, Ribeiro AF, Kerbauy LN, Fernandes JF, Kerbauy MN, Torres M, Kondo A, Kutner JM, Sodre Costa LS, Taba L, Savioli ML, de Sa GR, da Silva Costa C, da Silva LRR, Alves Pereira SF, Hamerschlak N. The Impact of FACT Accreditation Program in a Bone Marrow Transplantation Unit in Latin America: Improving Clinical Results. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00738-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shaw B, Wood E, McQuilten Z, Callum J, Romon I, Sanroma P, Garcia D, Crispin P, Castilho L, Kutner JM, Yokoyama APH, Bravo A, Sanchez EF, Silva KM, Arora S, Radhakrishnan N, Dua S, Ziman A, Wikman A, Lubenow N, Zingmark LB, Louw V, Loebenberg P, Sidhu D, Redfern T, Nahirniak S, Dunbar N. International Forum on Home-Based Blood Transfusion: Responses. Vox Sang 2021; 117:E44-E57. [PMID: 34697811 DOI: 10.1111/vox.13199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/27/2022]
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Shaw B, Wood E, McQuilten Z, Callum J, Romon I, Sanroma P, Garcia D, Crispin PJ, Castilho L, Kutner JM, Yokoyama APH, Bravo A, Sanchez EF, Maldonado Silva K, Arora S, Radhakrishnan N, Dua S, Ziman A, Wikman A, Lubenow N, Bodecker Zingmark L, Louw VJ, Loebenberg P, Sidhu D, Redfern T, Nahirniak S, Dunbar N. International Forum on Home-Based Blood Transfusion: Summary. Vox Sang 2021; 117:616-623. [PMID: 34697808 DOI: 10.1111/vox.13200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022]
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Torres DC, Yokoyama APH, Bub CB, Dametto APF, Sakashita AM, Santos LD, Velloso MCB, Durigon EL, Assunção MSC, Kutner JM. TRANSFUSÃO DE PLASMA CONVALESCENTE EM COVID19: ASSOCIAÇÃO ENTRE ANTICORPOS NEUTRALIZANTES E REDUÇÃO DE CARGA VIRAL. Hematol Transfus Cell Ther 2021. [PMCID: PMC8530592 DOI: 10.1016/j.htct.2021.10.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introdução A transfusão de plasma convalescente tem sido utilizada como terapêutica alternativa no tratamento de COVID19 nos últimos meses. Avaliamos o impacto dos anticorpos neutralizantes produzidos pelos pacientes e dos anticorpos presentes nas unidades transfundidas na redução da carga viral em pacientes em tratamento hospitalar de COVID19. Materiais e métodos Foram avaliados consecutivamente 29 pacientes admitidos para tratamento hospitalar de COVID19 em um único centro. Doses de 300 a 600 ml de plasma convalescente foram administradas ao longo de 2 dias. Foram coletados swabs nasais a cada 48 h a partir do D0 (dia de transfusão de plasma convalescente) até a alta hospitalar, a fim de determinar a carga viral por digital droplet PCR (ddPCR) dos alvos N1 e N2 do gene N (nucleocapsídeo) para análise de redução de carga viral, sendo considerado o número de cópias virais por 1000 células presente na amostra. Mensuramos os títulos de anticorpos neutralizantes (cytopathic effect-based virus neutralization test -SARS-CoV-2 GenBank MT126808.1) dos pacientes (NAbsP) antes da transfusão (D0) e títulos de anticorpos neutralizantes das unidades de plasma transfundidas (NAbsT). Para análise de associação entre NAbsP e redução de carga viral, os pacientes foram divididos em dois grupos de acordo com o status de NAbsP no D0: título de NabsP inferior a 80 e título de NabsP igual ou superior a 80. Para esta análise, foi utilizado o teste de Mann-Whitney . Para verificar a associação entre NAbsT e redução de carga viral, os pacientes foram divididos em três grupos: aqueles que receberam transfusão de plasma convalescente com título de NAbsT até 160, título de NAbsT entre 160-640 e NAbsT superior a 640. Para esta análise, foi utilizado o teste de Kruskall-Wallis. Resultados Pacientes com baixos títulos de neutralizantes à admissão (NAbsP inferior a 80) apresentaram redução de carga viral significativamente maior (p=0,009) que pacientes com NAbsP igual ou superior a 80. Com relação ao impacto da transfusão de plasma, observou-se que quanto maior o título de anticorpos neutralizantes transfundidos maior foi a redução da carga viral; porém, tal achado não apresentou significância estatística (p = 0,528). Discussão O combate e eliminação da viremia através dos anticorpos neutralizantes presentes no plasma convalescente compreende uma das justificativas da sua aplicação como terapia alternativa para COVID19. Contudo, estudos prévios demonstraram resultados contraditórios em relação ao seu impacto no clearance viral. Na presente casuística, pacientes com baixos títulos de anticorpos neutralizantes apresentaram maior redução de carga viral após a transfusão de plasma convalescente do que pacientes com altos títulos. Pacientes que já apresentavam títulos elevados de neutralizantes parecem não se beneficiar da transfusão de plasma no que se refere à redução de carga viral. A estratificação dos pacientes de acordo com os níveis basais de anticorpos neutralizantes parece ser um ponto importante a ser discutido no tratamento de COVID19 com plasma convalescente e fornece uma explicação plausível para os resultados controversos previamente observados.
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Cardigan R, New HV, Estcourt L, Zhiburt E, Dubey R, Bengtsson J, Jöud M, Castillo C, Cid J, Lozano M, Gounder D, Flanagan P, Morley S, Clarke G, Devine D, Hindawi S, AlOtaibi A, Bub CB, Kutner JM, Ikeda T, Goto N, Okazaki H, Fontaine MJ, Pasion J, Song L, Latham T, Kerkhoffs JL, de Haas M, Zwaginga JJ, Gathof BS, Ommer K, Pirenne F, Raba M, Francois A, Daly J, Powley T, Dunbar N. International Forum on Policies and Practice for Transfusion of ABO and RhD Non-Identical Platelets: Summary. Vox Sang 2021; 117:136-144. [PMID: 34258783 DOI: 10.1111/vox.13129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 01/16/2023]
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Cardigan R, New HV, Estcourt L, Zhiburt E, Dubey R, Bengtsson J, Jöud M, Castillo C, Cid J, Lozano M, Gounder D, Flanagan P, Morley S, Clarke G, Devine D, Hindawi S, AlOtaibi A, Bub CB, Kutner JM, Ikeda T, Goto N, Okazaki H, Fontaine MJ, Pasion J, Song L, Latham T, Kerkhoffs JL, de Haas M, Zwaginga JJ, Gathof BS, Ommer K, Pirenne F, Raba M, Francois A, Daly J, Powley T, Dunbar N. International Forum on Policies and Practice for Transfusion of ABO and RhD Non-Identical Platelets: Responses. Vox Sang 2021; 117:e1-e20. [PMID: 34258774 DOI: 10.1111/vox.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
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Lira SMDC, Levi JE, Bub CB, Aravecchia MG, Altman SN, Sakashita AM, Kutner JM. Zika virus RNA detection in blood donors in São Paulo, Brazil. Hematol Transfus Cell Ther 2021; 44:472-477. [PMID: 34148860 PMCID: PMC9605902 DOI: 10.1016/j.htct.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/28/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction: The Zika Virus (ZIKV) is a single-stranded RNA genome virus, belonging to the family Flaviviridae, genus Flavivirus. Outbreaks around the world have demonstrated that the presence of asymptomatic viremic blood donors provides an increase in the risk of transfusion transmission (TT) and nucleic acid test (NAT) screening has been proposed to ensure the blood safety. This study implemented an “in-house” method to detect ZIKV RNA in blood sample donations. Methods: Primary plasma tubes are submitted to nucleic acid extraction on an automated platform. After extraction, the NAT set-up is performed in the robotic pipettor, in which an amplification mixture containing primers and probes for ZIKV and Polio vaccine virus (PV) are added in duplex as an internal control. The real-time polymerase chain reaction is then performed in a thermocycler, using the protocol established by the supplier. Results: From May 2016 to May 2018, 3,369 samples were collected from 3,221 blood donors (confidence coefficient 95%), of which 31 were considered false positive (0.92%), as they did not confirm initial reactivity when repeated in duplicates and 14 (0.42%) had their results invalid due to repeat failure in the internal control, 4 (0.12%), due to insufficient sample volume and 2 (0.05%), due to automatic pipettor failures. No Zika RNA reactive sample was identified. Conclusion: The test showed feasible to be incorporated into the blood screening routine. Our data do not indicate the need to screen for ZIKV RNA in São Paulo during the evaluated period. However, a generic NAT system covering a group of flaviviruses which are circulating in the region, such as DENV and YFV, among others, could be a useful tool.
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Affiliation(s)
- Sanny Marcele da Costa Lira
- Instituto de Medicina Tropical, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo (IMTSP USP), São Paulo, SP, Brazil.
| | - Jose Eduardo Levi
- Instituto de Medicina Tropical, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo (IMTSP USP), São Paulo, SP, Brazil
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19
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Bezinelli LM, Corrêa L, Vogel C, Kutner JM, Ribeiro AF, Hamerschlak N, Eduardo CDP, Migliorati CA, Eduardo FDP. Long-term safety of photobiomodulation therapy for oral mucositis in hematopoietic cell transplantation patients: a 15-year retrospective study. Support Care Cancer 2021; 29:6891-6902. [PMID: 34021422 DOI: 10.1007/s00520-021-06268-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022]
Abstract
Photobiomodulation therapy (PBMT) has demonstrated efficacy in the prevention and treatment of oral mucositis (OM) in hematopoietic cell transplantation (HCT). However, based on the cell stimulation properties, its long-term safety has been questioned, mainly in relation to risk for secondary malignancies in the oral cavity. The aim of this study was to investigate if different PBMT protocols for OM control have association with immediate and late adverse effects in HCT patients. Data on autologous and allogeneic transplantation, conditioning regimen, PBMT protocols, and OM severity were retrospectively collected from medical and dental records. Presence of secondary malignancies in the oral cavity was surveyed during a 15-year follow-up. Impact of OM on overall survival was also analyzed. Different PBMT protocols for prevention and treatment of OM were recorded over the years. Severe OM (grades 3 and 4) was infrequently observed. When present, we observed a significant decrease of the overall survival. No immediate adverse effect and secondary malignancy was associated to PBMT. In conclusion, the PBMT protocols used in the study were considered safe. The low frequency of severe OM observed encourages the implementation of this technique, with a special emphasis on the dosimetry adjustments focused on the HCT context.
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Affiliation(s)
- Letícia Mello Bezinelli
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | - Luciana Corrêa
- School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cristina Vogel
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | - Jose Mauro Kutner
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | - Andreza Feitosa Ribeiro
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | - Nelson Hamerschlak
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil
| | | | - Cesar Augusto Migliorati
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Fernanda de Paula Eduardo
- Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/520, São Paulo, SP, CEP 05651-901, Brazil.
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20
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Barbagallo NBDA, Costa TH, Bastos E, Aravechia MG, Kutner JM, Bonet-Bub C. The relevance of a bank with genotyped platelets donors. Hematol Transfus Cell Ther 2021; 44:465-471. [PMID: 34083156 PMCID: PMC9605892 DOI: 10.1016/j.htct.2021.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/23/2021] [Accepted: 03/13/2021] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE Describe the clinical and laboratory characteristics and the transfusion strategy of patients at Hospital Israelita Albert Einstein with platelet refractoriness and identify their etiological characteristics. Standardize the platelet immunofluorescence technique by flow cytometry as a test for platelet compatibility in immune platelet refractoriness in transfusion support. METHODS Review of medical records of refractory platelet patients followed at HIAE from January 2011 to May 2017. Clinical-demographic data, laboratory data and identification of the use of compatible genotyped platelets for patients in need of transfusion therapy were collected. The analyzed patients were classified according to the etiology of their platelet refractoriness. To standardize the FC-PIFT technique, blood group O platelets were incubated with serum from blood group AB donors and anti-IgG monoclonal antibody to determine the negative control. In order to verify the influence of the ABO system, monoclonal anti-IgG antibodies were incubated with blood group A or B platelets and with blood group O donor serum with isohemagglutinins below and above 1/64. RESULTS A total of 47 patients were evaluated, a 51% (24/47) preponderance of associated immune and non-immune factors (NIPR + IPR). The most common causes of NIPR + IPR were splenomegaly (54%) and the development of HLA antibodies (88%), consistent with the literature. For patients who required therapeutic transfusion, only a small portion received compatible genotyped platelets. CONCLUSION Although 60% of patients could benefit from the therapeutic transfusion of genotyped platelets, only 10% were actually transfused with this type of blood component. This reaffirms the need for investments in a bank of genotyped platelet donors.
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Affiliation(s)
| | | | - Eduardo Bastos
- Hospital Israelita Albert Einstein (HIAE) São Paulo, SP, Brazil
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21
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Wheeler AP, Delaney M, Fung M, Gorlin J, Kutner JM, Lam JCM, Robitaille N, Saxon B, Stanworth SJ, Van De Watering L, Yokoyama APH, Haspel RL. Pediatric resident knowledge of transfusion medicine: Results from the BEST-TEST3 international education needs assessment. Transfusion 2021; 61:2487-2495. [PMID: 33969906 DOI: 10.1111/trf.16439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/10/2021] [Accepted: 03/29/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Transfusions are a common intervention within pediatrics and require unique considerations to optimize patient care. Poor knowledge of evidence-based transfusion practice can lead to misuse of transfusion therapy and harm. While there have been assessments of transfusion medicine knowledge of physicians caring for adult patients, there is little data regarding pediatricians. STUDY DESIGN AND METHODS Using a published transfusion medicine knowledge exam for internal medicine physicians as a backbone, pediatric transfusion medicine experts, using an iterative process, developed a pediatric-specific examination. Pilot testing and Rasch analysis, a method used in high-stakes testing, was used to validate the exam. The exam and a previously validated survey on transfusion medicine training, attitudes, and perceived ability were administered to pediatric residents. Analysis consisted of descriptive statistics as well as comparisons of exam scores based on survey responses. RESULTS 330 pediatric residents from 19 sites in 6 countries participated in the study. The vast majority (91%) of residents had obtained blood product consent. The mean exam score was 37.1% (range 9.5%-71.4%) with no statistical differences based on amount or perceived quality of transfusion medicine education or perceived ability. DISCUSSION A rigorously validated exam has now been developed that can be used to assess pediatric transfusion medicine knowledge. A large international group of pediatric residents performed poorly on the exam demonstrating a pressing need for improved transfusion medicine education to ensure safe and appropriate administration of blood components to infants and children.
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Affiliation(s)
- Allison P Wheeler
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Meghan Delaney
- Division of Pathology and Laboratory Medicine, Children's National Hospital Medical Center, Washington, District of Columbia, USA
| | - Mark Fung
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, Vermont, USA
| | - Jed Gorlin
- Transfusion Services, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Jose Mauro Kutner
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Joyce Ching Mei Lam
- Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Nancy Robitaille
- Division of Hematology-Oncology, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Ben Saxon
- Women's and Children's Hospital Adelaide, North Adelaide, South Australia, Australia
| | - Simon J Stanworth
- Department of Haematology, NHS Blood and Transplant/Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.,Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,Oxford BRC Haematology Theme, Oxford, UK
| | - Leo Van De Watering
- Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden, The Netherlands
| | - Ana P H Yokoyama
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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22
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Godoy JAP, Paiva RMA, Oliveira DC, Coa LL, Alvarez KCA, Okamoto OK, Marti LC, Kondo AT, Bortolini MAT, Castro R, Kutner JM. SENESCENCE STATE OF MESENCHYMAL STEM CELLS IN LOW CULTURE PASSAGES: IMPLICATIONS FOR CLINICAL USE. Cytotherapy 2021. [DOI: 10.1016/j.jcyt.2021.02.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Young P, Crowder L, Steele W, Irving D, Pink J, Kutner JM, Yokoyama APH, Van Buren N, O'Sullivan NW, Sayers M, Alcantara RM, van den Hurk K, Wiersum-Osselton J, Shaz B. Frequency of rare, serious donor reactions: International perspective. Transfusion 2021; 61:1780-1788. [PMID: 33665853 DOI: 10.1111/trf.16333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Severe blood donor adverse events are rare, but due to their rarity studying them can be difficult. To get an accurate estimate of their frequency and rate in the donor population it may be necessary to combine donation data across countries. STUDY DESIGN AND METHODS International blood collection organizations (BCOs) provided data on rare/severe donor reactions as well as denominator information for their donor populations from 2015 to 2017. Donor reactions were classified using standardized definitions. RESULTS BCOs from six countries provided reaction data for more than 22 million donations. A total of 480 rare reactions were reported of which 76.7% were imputed as definite and 11% probable. Rates of rare reactions were higher in females and first-time donors. Systemic rare reactions were the most common reaction type, accounting for over three quarters of reactions reported. Of systemic reactions, vasovagal reactions with loss of consciousness and injury or off-site (n = 350) made up the majority and occurred 1.53 per 100,000 donations. For the 22.3% that were localized reactions, the majority of these were cellulitis (n = 71, 0.31 per 100,000 donations) followed by deep venous thrombosis (n = 21, 0.09 per 100,000 donations). CONCLUSION Pulling together data from multiple BCOs across countries allows for a better understanding of rare reactions, such as vasovagal reaction with injury or cellulitis, and for generating a reliable incidence rate for air embolism or compartment syndrome. However, gaps remain due to missing elements such as unknown donor status or location of reaction.
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Affiliation(s)
- Pampee Young
- American Red Cross, Washington, District of Columbia, USA
| | - Lauren Crowder
- American Red Cross, Washington, District of Columbia, USA
| | - Whitney Steele
- American Red Cross, Washington, District of Columbia, USA
| | - David Irving
- Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Joanne Pink
- Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
| | - Jose Mauro Kutner
- Cell Therapy and Hemotherapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | - Nancy Van Buren
- Memorial Blood Centers, New York Blood Center Enterprises, Saint Paul, Minnesota, USA
| | | | | | | | | | | | - Beth Shaz
- Duke University, Durham, North Carolina, USA
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24
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Wendel S, Kutner JM, Machado R, Fontão‐Wendel R, Bub C, Fachini R, Yokoyama A, Candelaria G, Sakashita A, Achkar R, Hamerschlak N, Scuracchio P, Amaral M, Dal Ben M, Araujo D, Soares C, Camargo A, Kallás E, Durigon E, Reis LF, Rizzo LV. Screening for SARS-CoV-2 antibodies in convalescent plasma in Brazil: Preliminary lessons from a voluntary convalescent donor program. Transfusion 2020; 60:2938-2951. [PMID: 32935877 PMCID: PMC7756544 DOI: 10.1111/trf.16065] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/02/2020] [Accepted: 08/02/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) collection began in two Brazilian hospitals for treatment of severe/critical patients. METHODS AND MATERIALS Mild/moderate COVID-19 convalescents were selected as CCP donors after reverse transcription polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and absence of symptoms for ≥14 days plus (a) age (18-60 years), body weight greater than 55 kg; (b) immunohematological studies; (c) no infectious markers of hepatitis B virus, hepatitis C virus, human immunodeficiency virus, human T-lymphotropic virus-1/2, Chagas and syphilis infection; (d) no HLA antibodies (multiparous); (e) second RT-PCR (nasopharyngeal swab and/or blood) negativity; (f) virus neutralization test (cytopathic effect-based virus neutralization test neutralizing antibody) and anti-nucleocapsid protein SARS-CoV-2 IgM, IgG, and IgA enzyme-linked immunosorbent assays. RESULTS Among 271 donors (41 females, 230 males), 250 presented with neutralizing antibodies. Final RT-PCR was negative on swab (77.0%) or blood (88.4%; P = .46). Final definition of RT-PCR was only defined at more than 28 days after full recovery in 59 of 174 (33.9%) RT-PCR -ve, and 25/69 RT-PCR +ve (36.2%; 13 between 35 and 48 days). Neutralizing antibody titers of 160 or greater were found in 63.6%. Correlation between IgG signal/cutoff of 5.0 or greater and neutralizing antibody of 160 or greater was 82.4%. Combination of final RT-PCR -ve with neutralizing antibody ≥160 was 41.3% (112/271). Serial plasma collection showed decline in neutralizing antibody titers and IgA levels (P < .05), probably denoting a "golden period" for CCP collection (≤28 days after joining the program); IgA might have an important role as neutralizing antibody. Donor's weight, days between disease onset and serial plasma collection, and IgG and IgM levels are important predictors for neutralizing antibody titer. CONCLUSIONS RT-PCR +ve cases are still detected in 36.2% within 28 to 48 days after recovery. High anti-nucleocapsid protein IgG levels may be used as a surrogate marker to neutralizing antibody.
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Affiliation(s)
| | | | - Rafael Machado
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Carolina Bub
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | | | - Ana Yokoyama
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | | | - Araci Sakashita
- Hospital Israelita Albert Einstein Blood BankSão PauloBrazil
| | - Ruth Achkar
- Hospital Sírio‐Libanês Blood BankSão PauloBrazil
| | | | | | | | | | - Danielle Araujo
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | - Camila Soares
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Esper Kallás
- Infectious Disease DepartmentUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Edison Durigon
- Department of MicrobiologyInstitute of Biomedical Sciences, University of Sao PauloSão PauloBrazil
| | | | - Luiz Vicente Rizzo
- Albert Einstein Jewish Institute for Education and ResearchSão PauloBrazil
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25
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Bastos EP, Castilho L, Bub CB, Kutner JM. Comparison of ABO antibody titration, IgG subclasses and qualitative haemolysin test to reduce the risk of passive haemolysis associated with platelet transfusion. Transfus Med 2020; 30:317-323. [PMID: 32484285 DOI: 10.1111/tme.12687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/07/2020] [Accepted: 05/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND One of the strategies used to reduce the risk of haemolysis due to ABO-minor incompatible platelet transfusions is to perform a screening test to identify group O donors with high titres of anti-A and anti-B. However, critical immunoglobulin M/ immunoglobulin G (IgM/IgG) titres remain unclear. OBJECTIVE This study aimed to determine IgM titres of anti-A and anti-B in individual donor serum vs platelet products plasma and identify a possible association between IgM/IgG titres, haemolysin test and IgG subclasses in Brazilian blood donors from group O. METHODS IgM anti-A and Anti-B titration tests were performed on single-donor serum and platelet product plasma by gel agglutination (GA) at room temperature. For IgG anti-A and anti-B titration, serum was first treated with 0.01 M dithiothreitol (DTT), and the test was performed by GA with incubation at 37°C. Dilution of 1:64 as the cut-off was considered for both IgM/IgG. The qualitative haemolysin test was performed in tube, adding AB fresh serum, with incubation at 37°C. IgG subclasses were determined by GA using specific monoclonal antibodies. RESULTS An association between anti-A and anti-B IgM titres and haemolysin were demonstrated (P < .001). IgM titres in plasma samples from platelet components correlated to those in single-serum samples. IgG1/IgG3 subclasses were associated with total haemolysis and titres above 64, whereas IgG2/IgG4 subclasses were associated with the absence of haemolysis and titres below 64 (P < .001). CONCLUSION Our data suggest that a value of 64 as a critical titre can be used as a screening test of anti-A and anti-B IgM to prevent transfusion reactions. This can be a safe and cost-effective approach for managing ABO-incompatible platelet transfusions.
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Affiliation(s)
- Eduardo Peres Bastos
- Departamento de Hemoterapia e Terapia Celular, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Lilian Castilho
- Departamento de Hemoterapia e Terapia Celular, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Universidade Estadual de Campinas, São Paulo, Brazil
| | - Carolina Bonet Bub
- Departamento de Hemoterapia e Terapia Celular, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Jose Mauro Kutner
- Departamento de Hemoterapia e Terapia Celular, Hospital Israelita Albert Einstein, São Paulo, Brazil
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26
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Zeller MP, Ellingham D, Devine D, Lozano M, Lewis P, Zhiburt E, van der Linde L, Goldman M, Nakamura A, Inoue S, Takikawa M, Nakajima K, Turek P, Řeháček V, Sakashita AM, Kutner JM, Karim FA, Hindawi S, Jayasekara SBA, Merz EM, Gross S, Woimant G, Djoudi R, Byabazaire KD, Irving DO, Abdrakhmanova S, Khalykova A, Yilmaz S, Örűç NE, Huaynalaya IP, Ramirez LAS, Chuhriiev A. Vox Sanguinis International Forum on Donor Incentives: Summary. Vox Sang 2020; 115:339-344. [PMID: 32394471 DOI: 10.1111/vox.12868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Michelle P Zeller
- McMaster Centre for Transfusion Research, Department of Medicine, McMaster University, Canadian Blood Services, 1200 Main Street West, HSC 3H54, Hamilton, ON, L8N 3Z5, Canada
| | - Dana Ellingham
- Department of Medicine, McMaster Centre for Transfusion Research, Faculty of Health Sciences, McMaster University, 1280 Main Street West, HSC-3H50, Hamilton, ON, L8S 4K1, Canada
| | - Dana Devine
- Canadian Blood Services, UBC Centre for Blood Research, 2350 Health Sciences Mall, Vancouver, BC, V6T1Z3, Canada
| | - Miquel Lozano
- Department of Hemotherapy and Hemostasis, Hospital Clinic, Villaroel 170, Barcelona, 08036, Spain
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27
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Zeller MP, Ellingham D, Devine D, Lozano M, Lewis P, Zhiburt E, der Linde L, Goldman M, Nakamura A, Inoue S, Takikawa M, Nakajima K, Turek P, Řeháček V, Sakashita AM, Kutner JM, Karim FA, Hindawi S, Jayasekara SBA, Merz E, Gross S, Woimant G, Djoudi R, Byabazaire KD, Irving DO, Abdrakhmanova S, Khalykova A, Yilmaz S, Örűç NE, Huaynalaya IP, Ramirez LAS, Chuhriiev A. Vox Sanguinis International Forum on Donor Incentives. Vox Sang 2020; 115:e1-e18. [DOI: 10.1111/vox.12869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Delaney M, Apelseth TO, Bonet Bub C, Cohn CS, Dunbar NM, Mauro Kutner J, Murphy M, Perelman I, Selleng K, Staves J, Wendel S, Ziman A. Red-blood-cell alloimmunization and prophylactic antigen matching for transfusion in patients with warm autoantibodies. Vox Sang 2020; 115:515-524. [PMID: 32249930 DOI: 10.1111/vox.12914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/26/2020] [Accepted: 03/02/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Warm autoantibodies (WAA) are antibodies that react with an antigen on a patient's own red-blood-cells and can complicate compatibility testing whether or not they cause clinical haemolysis. The goal of this study was to understand the overall prevalence of WAA, the risk of RBC alloimmunization and determine whether RBC selection practices have an impact on alloimmunization. MATERIALS AND METHODS Records of patients (>1 year of age) with an indirect antibody detection test (IAT) and serologic evidence of WAA over a 10-year-period were included. Eight centres from 5 countries collectively reviewed 1 122 245 patients who had an IAT. RESULTS Of patients having IAT, 1214 had WAA (0·17%). Transfusion information for 1002 of the patients was available; 631 were transfused after identification of the WAA (63%); of the transfused patients, 390 received prophylactic antigen-matched (PAM) RBCs and 241 did not. Of the 372 patients with WAA who were transfused and had serologic testing 30+ days following transfusion (30-2765 days), 56 developed new RBC alloimmunization (15·1%). Patients who were transfused using a PAM strategy were not protected from new RBC alloimmunization [14·6% (31 of 212 patients) having PAM transfusion approach compared with those not receiving PAM approach (15·6%, 25 of 160 patients, P = 0·8837)]. CONCLUSIONS The prevalence of WAA in patients having an IAT is low (<1%). A significant portion of patients with WAA form new RBC alloimmunization (15·1%); however, the use of PAM approach for RBC selection was not found to be protective against new alloimmunization.
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Affiliation(s)
- Meghan Delaney
- Bloodworks NW, Department of Laboratory Medicine, University of Washington, Seattle, WA, USA
| | - Torunn Oveland Apelseth
- Department of Immunology and Transfusion Medicine, Department of Clinical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | | | - Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Michael Murphy
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Kathleen Selleng
- Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Julie Staves
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Alyssa Ziman
- Wing-Kwai and Alice Lee-Tsing Chung Transfusion Service, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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29
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Zalpuri S, Romeijn B, Allara E, Goldman M, Kamel H, Gorlin J, Vassallo R, Grégoire Y, Goto N, Flanagan P, Speedy J, Buser A, Kutner JM, Magnussen K, Castrén J, Culler L, Sussmann H, Prinsze FJ, Belanger K, Compernolle V, Tiberghien P, Cardenas JM, Gandhi MJ, West KA, Lee C, James S, Wells D, Sutor LJ, Wendel S, Coleman M, Seltsam A, Roden K, Steele WR, Bohonek M, Alcantara R, Di Angelantonio E, den Hurk K. Variations in hemoglobin measurement and eligibility criteria across blood donation services are associated with differing low‐hemoglobin deferral rates: a BEST Collaborative study. Transfusion 2020; 60:544-552. [DOI: 10.1111/trf.15676] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Saurabh Zalpuri
- Donor Studies, Department of Donor Medicine ResearchSanquin Research Amsterdam The Netherlands
| | - Bas Romeijn
- Donor Studies, Department of Donor Medicine ResearchSanquin Research Amsterdam The Netherlands
| | - Elias Allara
- Department of Public Health and Primary CareUniversity of Cambridge Cambridge United Kingdom
| | - Mindy Goldman
- Medical Services and Innovation, Canadian Blood Services Ottawa Ontario Canada
| | | | - Jed Gorlin
- Physician Services, Innovative Blood Centers St. Paul Minnesota
| | | | - Yves Grégoire
- Medical Affairs and Innovation, Héma‐Québec Quebec City Canada
| | - Naoko Goto
- Safety Vigilance Department, Technical DepartmentBlood Service Headquarters, Japanese Red Cross Society Tokyo Japan
| | | | - Joanna Speedy
- Australian Red Cross Blood Service Adelaide South Australia Australia
| | - Andreas Buser
- Regional Blood Transfusion Service, Swiss Red Cross Basel Switzerland
| | | | - Karin Magnussen
- Blood Centre and Laboratory Medicine, Innlandet Hospital Lillehammer Oppland Norway
| | | | - Liz Culler
- Blood Assurance, Inc Chattanooga Tennessee
| | | | - Femmeke J. Prinsze
- Donor Studies, Department of Donor Medicine ResearchSanquin Research Amsterdam The Netherlands
| | | | | | | | | | | | - Kamille A. West
- National Institutes of Health Clinical Center Bethesda Maryland
| | - Cheuk‐Kwong Lee
- Hong Kong Red Cross Blood Transfusion Service Kowloon Hong Kong SAR China
| | - Sian James
- Welsh Blood Service Wales United Kingdom
| | - Deanne Wells
- Community Blood Center of the Carolinas Charlotte North Carolina
| | | | | | | | | | | | | | - Milos Bohonek
- Military University Hospital Prague Czech Republic PragueBohemia
| | - Ramir Alcantara
- Health Sciences Authority Blood Services Group Singapore Singapore
| | | | - Katja den Hurk
- Donor Studies, Department of Donor Medicine ResearchSanquin Research Amsterdam The Netherlands
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Crusoe EDQ, Higashi F, Martinez G, Bittencourt R, Pinto Neto JV, Sousa L, Santucci R, Magalhães RJP, Colli G, Nunes RFM, Ribeiro G, Nicacio J, Zanella KR, Kutner JM, Magalhaes A, Leao D, Hallack Neto AE, Braga W, Souza EG, Guimaraes AJAM, Durigon GS, Laks D, Maiolino A, Hungria VTDM. Superiority of the triple combination of bortezomib, cyclophosphamide and dexamethasone versus cyclophosphamide, thalidomide and dexamethasone in patients with newly diagnosed multiple myeloma, eligible for transplantation. Hematol Transfus Cell Ther 2019; 42:118-124. [PMID: 31537476 PMCID: PMC7248497 DOI: 10.1016/j.htct.2019.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/05/2018] [Accepted: 05/01/2019] [Indexed: 11/30/2022] Open
Abstract
Background The treatment of multiple myeloma (MM) has evolved significantly in the past decade, and new drug combinations have improved the response rates and prolonged survival. Studies comparing different induction chemotherapy regimens have shown that triple combinations have better results than double combinations. However, comparisons among different triple combinations are rare in the literature. Methods We retrospectively compared two triple combinations comprising bortezomib, cyclophosphamide and dexamethasone (VCD) versus thalidomide, cyclophosphamide and dexamethasone (CTD), and aimed at identifying which of the two combinations would yield better response rates following four induction cycles prior to hematopoietic cell transplantation in patients with untreated multiple myeloma. Results We retrospectively reviewed the medical records of 311 patients from 24 different centers.The VCD regimen was used as induction therapy by 117 (37.6%) patients, whereas 194 (62.4%) patients received the CTD regimen. After four cycles of induction on an intention-to-treat basis, 54% of the patients in the VCD group achieved at least very good partial response versus 42.8% in the CTD group (p = 0.05). We observed no difference in neuropathy or thrombotic events rates among the two regimens. Conclusion Our results corroborate the superiority of the triple combination regimes containing bortezomib over the triple combination with thalidomide as pre ASCT induction therapy in MM.
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Affiliation(s)
- Edvan De Queiroz Crusoe
- Universidade Federal da Bahia (UFBA), Hospital Universitário Professor Edgard Santos, Salvador, BA, Brazil.
| | - Fabiana Higashi
- Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Gracia Martinez
- Universidade de São Paulo Faculdade de Medicina (USP), Hospital das Clinicas Instituto do Cancer, São Paulo, SP, Brazil
| | | | | | - Lais Sousa
- Centro de Hematologia e Oncologia, Clínica CEHON Salvador, BA, Brazil
| | | | - Roberto José Pessoa Magalhães
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, RJ, Brazil
| | - Gilberto Colli
- Hospital de Câncer de Barretos, Fundação Pio XII, Barretos, SP, Brazil
| | | | | | | | | | | | - Andre Magalhaes
- Clínica CEHON - Centro de Hematologia e Oncologia, Juazeiro, BA, Brazil
| | - Danielle Leao
- Hospital das Clínicas de Goiás, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil
| | | | - Walter Braga
- Univsersidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Emanuella G Souza
- Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas da Belo Horizonte, MG, Brazil
| | | | | | - Dani Laks
- Instituto de Hematologia, Porto Alegre, RS, Brazil
| | - Angelo Maiolino
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, RJ, Brazil
| | - Vania Tietsche de Moraes Hungria
- Clínica São Germano, São Paulo, SP, Brazil; Faculdade de Ciências Médicas da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
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31
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Santos LD, Bub CB, Aravechia MG, Bastos EP, Kutner JM, Castilho L. The rare holley antibody associated with a severe hemolytic transfusion reaction: the importance of this antibody identification to find a compatible blood unit. Einstein (Sao Paulo) 2019; 18:eRC4582. [PMID: 31531557 PMCID: PMC6905162 DOI: 10.31744/einstein_journal/2020rc4582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 01/30/2019] [Indexed: 11/05/2022] Open
Abstract
The correct identification of erythrocyte antibodies is fundamental for the searching for compatible blood and haemolytic transfusion reactions prevention. Antibodies against antigens of high prevalence are difficult to identify because of the rarity of their occurrence and unavailability of negative red cells for confirmation. We report a case of 46-years-old woman, diagnosed with hemoglobinopathy, and who had symptomatic fall in hemoglobin levels (5.3g/dL) after blood transfusion suggestive of transfusion reaction. The patient's blood type was O RhD-positive. Irregular antibody screening was positive and demonstrated a panreaction against all erythrocytes tested, but this result was not reactive with dithiothreitol. Using negative red cells for antigens of high prevalence of our inventory we could identify in the serum of the same erythrocytes an anti-Holley antibody associated with anti-E. Molecular analysis confirmed that the patient was negative for E and Holley antigens. The crossmath with compatible units confirmed the results. Holley is a high prevalence antigen of the Dombrock blood system whose negative phenotype is extremely rare in all populations and is associated with hemolytic transfusion reactions. This is an antibody that is difficult to identify because laboratories need to have experience in solving complex cases, and have available a large stock of rare sera and erythrocytes, as well other tools such as enzymes, thiol reagents and molecular tests. The correct identification of a rare antibody is initial and mandatory for searching of compatible donors, and to guarantee a satisfactory transfusional support.
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Kerbauy LN, Kerbauy MN, Bautzer V, Chapchap EC, de Mattos VRP, da Rocha JDA, Esteves I, Kutner JM, Kerbauy FR, Ribeiro AAF, Machado CM, Hamerschlak N, Santos FPDS. Severe hemorrhagic cystitis caused by the BK polyomavirus is associated with decreased survival post‐allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2019; 21:e13101. [DOI: 10.1111/tid.13101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/21/2019] [Accepted: 04/06/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Lucila Nassif Kerbauy
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Mariana Nassif Kerbauy
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Vivien Bautzer
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Eduardo Cerello Chapchap
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Vinicius Renan Pinto de Mattos
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Juliana Dall’ Agnol da Rocha
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Iracema Esteves
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Jose Mauro Kutner
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Fabio Rodrigues Kerbauy
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Andreza Alice Feitosa Ribeiro
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Clarisse Martins Machado
- Instituto Israelita de Ensino e Pesquisa – IIEP Hospital Israelita Albert Einstein São Paulo Brazil
- Virology Laboratory, Institute of Tropical Medicine University of São Paulo São Paulo Brazil
| | - Nelson Hamerschlak
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
| | - Fabio Pires de Souza Santos
- Department of Hematology and Stem Cell Transplantation, Centro de Hematologia e Oncologia Família Dayan‐Daycoval Hospital Israelita Albert Einstein São Paulo Brazil
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33
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De Vooght KMK, Lozano M, Bueno JL, Alarcón A, Romera I, Suzuki K, Zhiburt E, Holbro A, Infanti L, Buser A, Hustinx H, Deneys V, Frélik A, Thiry C, Murphy M, Staves J, Selleng K, Greinacher A, Kutner JM, Bonet Bub C, Castilho L, Kaufman RM, Colling ME, Perseghin P, Incontri A, Dassi M, Brilhante D, Macédo A, Cserti-Gazdewich C, Pendergrast JM, Hawes J, Lundgren MN, Storry JR, Jain A, Marwaha N, Sharma RR. International Forum on typing and matching strategies in patients on anti-CD38 monoclonal therapy. Vox Sang 2018; 113. [PMID: 29947125 DOI: 10.1111/vox.12652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - J-L Bueno
- Haematology and Haemotherapy Department, Hospital Universitario Puerta de Hierro - Majadahonda, Joaquín Rodrigo 2, Majadahonda, 28222, Madrid, Spain
| | - A Alarcón
- Haematology and Haemotherapy Department, Hospital Universitario Puerta de Hierro - Majadahonda, Joaquín Rodrigo 2, Majadahonda, 28222, Madrid, Spain
| | - I Romera
- Haematology and Haemotherapy Department, Hospital Universitario Puerta de Hierro - Majadahonda, Joaquín Rodrigo 2, Majadahonda, 28222, Madrid, Spain
| | - K Suzuki
- Department of Internal Medicine, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
| | - E Zhiburt
- Blood Transfusion Department, Pirogov Russian National Medical Surgical Center, 70, Nizhnyaya Pervomaiskaya ul, Moscow, 105203, Russia
| | - A Holbro
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
- Hematology, University Hospital Basel, Hebelstrasse 10, Basel, 4031, Switzerland
| | - L Infanti
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
- Hematology, University Hospital Basel, Hebelstrasse 10, Basel, 4031, Switzerland
| | - A Buser
- Regional Blood Transfusion Service, Swiss Red Cross, Basel, Switzerland
- Hematology, University Hospital Basel, Hebelstrasse 10, Basel, 4031, Switzerland
| | - H Hustinx
- National Reference Laboratory, Swiss Blood Transfusion Service, Interregional Blood Transfusion Service SRC Ltd, Murtenstrasse 133, Bern, 3008, Switzerland
| | - V Deneys
- Immunohematology Laboratory, CHU UCL Namur, Godinne Hospital, Rue Dr Gaston Therasse 1, 5530, Yvoir, Belgium
| | - A Frélik
- Immunohematology Laboratory, CHU UCL Namur, Godinne Hospital, Rue Dr Gaston Therasse 1, 5530, Yvoir, Belgium
| | - C Thiry
- Immunohematology Laboratory, CHU UCL Namur, Godinne Hospital, Rue Dr Gaston Therasse 1, 5530, Yvoir, Belgium
| | - M Murphy
- NHS Blood & Transplant, Oxford University Hospitals, NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - J Staves
- Oxford University Hospitals, NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - K Selleng
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Sauerbruchstr, Greifswald, 17475, Germany
| | - A Greinacher
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Sauerbruchstr, Greifswald, 17475, Germany
| | - J M Kutner
- Departamento de Hemoterapia, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701 - Morumbi, São Paulo - SP, 05652-900, Brazil
| | - C Bonet Bub
- Departamento de Hemoterapia, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701 - Morumbi, São Paulo - SP, 05652-900, Brazil
| | - L Castilho
- Departamento de Hemoterapia, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701 - Morumbi, São Paulo - SP, 05652-900, Brazil
| | - R M Kaufman
- Brigham and Women's Hospital, Blood Bank, Amory 260, 75 Francis Street, Boston, MA, 02115, USA
| | - M E Colling
- Brigham and Women's Hospital, Blood Bank, Amory 260, 75 Francis Street, Boston, MA, 02115, USA
| | - P Perseghin
- Laboratorio di Criobiologia, UOS Aferesi e nuove tecnologie trasfusionali, ASST-Monza Ospedale San Gerardo, Via Pergolesi 33, 20900, Monza, Italy
| | - A Incontri
- Laboratorio di Immunoematologia, UOS Aferesi e nuove tecnologie trasfusionale, ASST-Monza, Ospedale San Gerardo, Via Pergolesi 33, 20900, Monza, Italy
| | - M Dassi
- Laboratorio di Immunoematologia, UOS Aferesi e nuove tecnologie trasfusionale, ASST-Monza, Ospedale San Gerardo, Via Pergolesi 33, 20900, Monza, Italy
| | - D Brilhante
- Serviço de Imunohemoterapia, Instituto Português de Oncologia Lisboa Francisco Gentil, EPE, Lisboa, Portugal
| | - A Macédo
- Serviço de Imunohemoterapia, Instituto Português de Oncologia Lisboa Francisco Gentil, EPE, Lisboa, Portugal
| | - C Cserti-Gazdewich
- Department of Laboratory Hematology (Transfusion Medicine), University Health Network, 200 Elizabeth Street, UHN TGH BTL 3EC-306, Toronto, ON, M5G 2C4, Canada
| | - J M Pendergrast
- Department of Laboratory Hematology (Transfusion Medicine), University Health Network, 200 Elizabeth Street, UHN TGH BTL 3EC-306, Toronto, ON, M5G 2C4, Canada
| | - J Hawes
- Department of Laboratory Hematology (Transfusion Medicine), University Health Network, 200 Elizabeth Street, UHN TGH BTL 3EC-306, Toronto, ON, M5G 2C4, Canada
| | - M N Lundgren
- Deparment of Clinical Immunology and Transfusion Medicine, Labmedicin Skane, Akutgatan 8, Lund, SE-22185, Sweden
| | - J R Storry
- Deparment of Clinical Immunology and Transfusion Medicine, Labmedicin Skane, Akutgatan 8, Lund, SE-22185, Sweden
| | - A Jain
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - N Marwaha
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
| | - R R Sharma
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India
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de Vooght KMK, Lozano M, Bueno JL, Alarcón A, Romera I, Suzuki K, Zhiburt E, Holbro A, Infanti L, Buser A, Hustinx H, Deneys V, Frélik A, Thiry C, Murphy M, Staves J, Selleng K, Greinacher A, Kutner JM, Bonet Bub C, Castilho L, Kaufman R, Colling ME, Perseghin P, Incontri A, Dassi M, Brilhante D, Macêdo A, Cserti-Gazdewich C, Pendergrast JM, Hawes J, Lundgren MN, Storry JR, Jain A, Marwaha N, Sharma RR. Vox Sanguinis International Forum on typing and matching strategies in patients on anti-CD38 monoclonal therapy: summary. Vox Sang 2018; 113:492-498. [PMID: 29781081 DOI: 10.1111/vox.12653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- K M K de Vooght
- Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M Lozano
- Department of Hemotherapy and Hemostasis, University Clinic Hospital, University of Barcelona, Barcelona, Spain
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35
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Kerbauy MN, Kerbauy LN, Esteves I, Rocha JD, Stanzione RL, Rodrigues M, Fernandes JF, Kutner JM, Sobrinho JJ, Mantovani LFAL, Kerbauy FR, Ribeiro AF, Hamerschlak N. Hospital Length of Stay and Impact of Readmission in the First 100 Days of Allogeneic Stem Cell Transplantation: Comparison among Alternative Donor in Pediatric and Adult Population. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Cohn CS, Dumont LJ, Lozano M, Marks DC, Johnson L, Ismay S, Bondar N, T'Sas F, Yokoyama APH, Kutner JM, Acker JP, Bohonek M, Sailliol A, Martinaud C, Pogłód R, Antoniewicz-Papis J, Lachert E, Pun PBL, Lu J, Cid J, Guijarro F, Puig L, Gerber B, Alberio L, Schanz U, Buser A, Noorman F, Zoodsma M, van der Meer PF, de Korte D, Wagner S, O'Neill M. Vox Sanguinis International Forum on platelet cryopreservation: Summary. Vox Sang 2017; 112:684-688. [PMID: 28929502 DOI: 10.1111/vox.12533] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, D242 Mayo Building, MMC 609, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - L J Dumont
- Blood Systems Research Institute Denver, 717 Yosemite Street, Denver, CO, 80230, USA
| | - M Lozano
- Department of Hemotherapy and Hemostasis, University Clinic Hospital, University of Barcelona, 08036, Barcelona, Spain
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37
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Yazer MH, van de Watering L, Lozano M, Sirdesai S, Rushford K, Wood EM, Yokoyama AP, Kutner JM, Lin Y, Callum J, Cserti-Gazdewich C, Lieberman L, Pendergrast J, Pendry K, Murphy MF, Selleng K, Greinacher A, Marwaha N, Sharma R, Jain A, Orlin Y, Yahalom V, Perseghin P, Incontri A, Masera N, Okazaki H, Ikeda T, Nagura Y, Zwaginga JJ, Pogłod R, Rosiek A, Letowska M, Yuen J, Cid J, Harm SK, Adhikari P. Development of RBC transfusion indications and the collection of patient-specific pre-transfusion information. Vox Sang 2017; 112:e22-e47. [PMID: 28524359 DOI: 10.1111/vox.12509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - S Sirdesai
- Department of Clinical Haematology, Monash Health, Melbourne, Victoria, Australia
| | - K Rushford
- Monash Pathology, Monash Health, Melbourne, Victoria, Australia
| | - E M Wood
- Department of Clinical Haematology Monash Health and Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - A P Yokoyama
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Bloco E, São Paulo, SP, 05651-901, Brazil
| | - J M Kutner
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Bloco E, São Paulo, SP, 05651-901, Brazil
| | - Y Lin
- Department of Clinical Pathology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room B2-04, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, 2075 Bayview Avenue, Room B2-04, Toronto, ON, M4N 3M5, Canada
| | - J Callum
- Department of Clinical Pathology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room B2-04, Toronto, ON, Canada
| | - C Cserti-Gazdewich
- Department of Medicine / Laboratory Medicine & Pathobiology, University of Toronto, Toronto General Hospital 3EC-306, 200 Elizabeth Street, Toronto, ON, Canada, M5G-2C4.,Laboratory Medicine Program, Laboratory Hematology: Blood Transfusion Laboratory, University Health Network, Toronto General Hospital 3EC-306, 200 Elizabeth Street, Toronto, ON, Canada, M5G-2C4
| | - L Lieberman
- Department of Laboratory Hematology (Transfusion Medicine), University Health Network, 200 Elizabeth Street, Suite 306, Toronto, ON, Canada, M5G 2C4
| | - J Pendergrast
- Department of Laboratory Hematology (Transfusion Medicine), University Health Network, 200 Elizabeth Street, Suite 306, Toronto, ON, Canada, M5G 2C4
| | - K Pendry
- Central Manchester University Hospitals, NHS Foundation Trust, Oxford Rd, Manchester, M13 9WL.,NHS Blood and Transplant Manchester Blood Centre, Plymouth Grove, Manchester, M13 9LL, UK
| | - M F Murphy
- Blood Transfusion Medicine, University of Oxford, Headley Way, Headington, Oxford, OX3 9BQ, UK.,NHS Blood andTransplant and Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford, OX3 9BQ, UK.,NHS Blood & Transplant, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9BQ, UK
| | - K Selleng
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Sauerbruchstrasse, 17475, Greifswald, Germany
| | - A Greinacher
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Sauerbruchstrasse, 17475, Greifswald, Germany
| | - N Marwaha
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - R Sharma
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - A Jain
- Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Y Orlin
- Transfusion & Apheresis Services, Rabin Medical Center, Petach Tikva, Israel
| | - V Yahalom
- Transfusion & Apheresis Services, Rabin Medical Center, Petach Tikva, Israel
| | - P Perseghin
- UOS Aferesi e nuove tecnologie trasfusionali-Laboratorio di Criobiologia, ASST-Monza Ospedale San Gerardo, Via Pergolesi 33, Monza (MB), 20900, Italy
| | - A Incontri
- UOS Aferesi e nuove tecnologie trasfusionali, ASST-Monza Ospedale San Gerardo, Via Pergolesi 33, Monza (MB), 20900, Italy
| | - N Masera
- Clinica Pediatrica, Università di Milano Bicocca and A. O. San Gerardo, Via Pergolesi 33, Monza (MB), 20900, Italy
| | - H Okazaki
- Department of Blood Transfusion, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - T Ikeda
- Department of Blood Transfusion, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Y Nagura
- Department of Blood Transfusion, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - J J Zwaginga
- Department of Immunohematology and Bloodtransfusion, Center for Stem Cell Therapies, Leiden University Medical Center, Albinusdreef 2, Building 1, E3-Q P.O. Box 9600, 2300, RC Leiden, The Netherlands
| | - R Pogłod
- Department of Transfusion Medicine, Institute of Hematology and Transfusion Medicine, ul. Indira Gandhi 14, Warsaw, 02-776, Poland
| | - A Rosiek
- Department for Quality Assurance and Organization of Blood Transfusion Service, Institute of Hematology and Transfusion Medicine, ul. Indira Gandhi 14, Warsaw, 02-776, Poland
| | - M Letowska
- Department for Diagnostics for Hematology and Transfusion Service, Institute of Hematology and Transfusion Medicine, ul. Indira Gandhi 14, Warsaw, 02-776, Poland
| | - J Yuen
- Blood Transfusion Services, Department of Laboratory Medicine, Tan Tock Seng Hospital, Level 2 - Podium Block, 11 Jalan Tan Tock Seng, 308433, Singapore
| | - J Cid
- Apheresis Unit, Department of Hemotherapy and Hemostasis, Hospital Clínic, Villarroel 170, 08036 Barcelona, Catalonia, Spain
| | - S K Harm
- University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT, 05401, USA
| | - P Adhikari
- University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT, 05401, USA
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Yazer MH, van de Watering L, Lozano M, Sirdesai S, Rushford K, Wood EM, Yokoyama AP, Kutner JM, Lin Y, Callum J, Cserti-Gazdewich C, Lieberman L, Pendergrast J, Pendry K, Murphy MF, Selleng K, Greinacher A, Marwaha N, Sharma R, Jain A, Orlin Y, Yahalom V, Perseghin P, Incontri A, Masera N, Okazaki H, Ikeda T, Nagura Y, Zwaginga JJ, Pogłod R, Rosiek A, Letowska M, Yuen J, Cid J, Harm SK, Adhikari P. Development of RBC transfusion indications and the collection of patient-specific pre-transfusion information: summary. Vox Sang 2017; 112:487-494. [PMID: 28524235 DOI: 10.1111/vox.12496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M H Yazer
- The Institute for Transfusion Medicine, University of Pittsburgh and University of Southern Denmark, 3636 Blvd of the Allies, Pittsburgh, PA, 15213, USA
| | - L van de Watering
- Jon J van Rood Center for Clinical Transfusion Research, Sanquin - LUMC, Plesmaniaan 1a, Leiden, 2333 BZ, the Netherlands
| | - M Lozano
- Department of Hemotherapy and Hemostasis, University Clinic Hospital, Villaroel 170, Barcelona, 08036, Spain
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Levi JE, Lira SM, Bub CB, Polite MB, Terzian CC, Kutner JM. Contrasting HCV and HIV seroepidemiology in 11 years of blood donors screening in Brazil. Transfus Med 2017; 27:286-291. [PMID: 28524366 DOI: 10.1111/tme.12427] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 04/07/2017] [Accepted: 04/30/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Blood donors are, in principle, healthy individuals who may be revealed as infectious for blood-borne agents by the laboratory screening process, depicting the asymptomatic burden of the disease. Therefore, monitoring hepatitis C virus (HCV)-infected donor and human immunodeficiency virus (HIV)-infected donor and associating to their demographical and behavioural characteristics may shed light on the dynamics and contemporary changes in these viruses' epidemiology. METHODS Donors presenting repeatedly reactive HCV or HIV serology/nucleic acid testing (NAT) screening results were submitted to confirmatory testing. Confirmed positive donors were invited to return to the blood bank for notification and counselling when a follow-up sample was obtained and an interview performed to eventually disclose potential risks. HCV- or HIV-infected donors identified over 11 years of screening (2004-2015) were evaluated for demographic and behavioural parameters. RESULTS In the period, 139 160 donations were screened, and 36 (0.025%) were found positive for HIV, stemming from 29 male and 7 female donors. Among those, eight subjects were repeat donors. A total of 95 donations were found repeatedly reactive for HCV (0.068%), obtained from 60 men and 35 women. Noticeably, in despite of a higher HCV prevalence in the donor population, the incidence of HIV among repeat donors was 10 times that of HCV (18 × 1.6/100 000 persons-year, respectively). On average, HIV-seroreactive men were found to be younger (mean = 34 years old) than women (mean = 40 years old). A total of 10 donors acknowledged sexual behaviours not previously informed, including 2 who were aware of their HIV-positive status and another 2 who admitted to be seeking HIV testing. No window period donation was verified. DISCUSSION The majority of the HIV-infected donors are young males who deny risk factors in the interview and also ignore the confidence self-exclusion opportunity. As they may reiterate this behaviour in serial donations, use of the most sensitive laboratory testing is justified in this setting.
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Affiliation(s)
- J E Levi
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - S M Lira
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - C B Bub
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - M B Polite
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - C C Terzian
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - J M Kutner
- Hemotherapy and Cell Therapy Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
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Ribeiro AF, Fernandes JF, da Silva CC, Sobrinho JJ, Kutner JM, Rodrigues M, Esteves I, Kerbauy FR, Kerbauy MN, Kerbauy LN, Hamerschlak N. Unmanipulated Haploidentical Transplants Using Post-Transplant Cyclophosphamide CAN Safely Extend Hematopoietic STEM CELL Transplantation for Patients Without an HLA Matched DONOR: Preliminary Results in Brazil. Biol Blood Marrow Transplant 2017. [DOI: 10.1016/j.bbmt.2016.12.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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41
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Cruz RDO, Mota MA, Conti FM, Pereira RAD, Kutner JM, Aravechia MG, Castilho L. Prevalence of erythrocyte alloimmunization in polytransfused patients. Einstein (Sao Paulo) 2016; 9:173-8. [PMID: 26760811 DOI: 10.1590/s1679-45082011ao1777] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
OBJECTIVE To determine the incidence and the rate of red blood cell alloimmunization in polytransfused patients. METHODS A polytransfused patient was defined as having received at least 6 units of red cell concentrates during a 3-month period. The records of all patients (n = 12,904) who had received red blood cell units were examined retrospectively by searching the computer database at Hospital Israelita Albert Einstein in São Paulo, Brazil, over a 6-year period, between 2003 and 2009. RESULTS During this time, 77,049 red cell concentrate transfusions were performed in 12,904 patients. There were 3,044 polytransfused patients, 227 of whom (7.5%) presented with irregular erythrocyte antibodies. The prevalence of alloantibody specificity was: Anti-E>anti-D>anti-K>anti-C>anti-Dia>anti-c>anti-Jka>anti-S in 227 polytransfused patients. We found combinations of alloantibodies in 79 patients (34.8%), and the most common specificities were against the Rh and/or Kell systems. These antibodies show clinical significance, as they can cause delayed hemolytic transfusion reactions and perinatal hemolytic disease. About 20% of the patients showed an IgG autoantibody isolated or combined with alloantibodies. Interestingly, a high incidence of antibodies against low frequency antigens was detected in this study, mainly anti-Dia. CONCLUSION Polytransfused patients have a high probability of developing alloantibodies whether alone or combined with autoantibodies and antibodies against low frequency antigens. Transfusion of red blood cells with a phenotype-compatible with RH (C, E, c), K, Fya, and Jka antigens is recommended for polytransfused patients in order to prevent alloimmunization and hemolytic transfusion reactions.
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Affiliation(s)
| | | | | | | | | | | | - Lilian Castilho
- Universidade Estadual de Campinas - UNICAMP, Campinas, SP, BR
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Levi JE, Cabral SPN, Nishiya A, Ferreira S, Romano CM, Polite MBC, Pereira RAA, Mota MA, Kutner JM. Absence of nonprimate hepacivirus-related genomes in blood donors seroreactive for hepatitis C virus displaying indeterminate blot patterns. J Viral Hepat 2014; 21:e164-6. [PMID: 24689976 DOI: 10.1111/jvh.12252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 02/13/2014] [Indexed: 12/09/2022]
Abstract
Despite intensive search, no primate homologue to the Hepatitis C Virus (HCV) has ever been found. The search for a zoonotic origin for HCV has been renewed recently when a virus, now known as non-primate hepacivirus (NPHV), with a high homology to HCV was found in dogs. A variable proportion of anti-HCV reactive blood donors submitted to the immunoblot (IB) to confirm their HCV status, present indeterminate results. The degree of homology between HCV and NPHV suggests that humans may be infected by NPHV or NPHV-like viruses. Maximum similarity between NHPV and HCV is observed in the nonstructural regions 3 and 5. Peptides representing both domains are present in IB assays, so it is reasonable to suppose that blood donors harboring such viruses may display cross-reactivity to the HCV antigenic fractions. Fifty-nine plasma samples from blood donors found reactive for anti-HCV and presenting IB indeterminate results were submitted to five distinct PCR reactions under low-stringency conditions, employing primers targeting GBV-C 5'UTR and NS3, Flavivirus-genus NS5 and NPHV 5'UTR and NS3. No amplification was obtained with all primer pairs tested except for five samples that amplified both 5'UTR and NS3 fragments from GBV-C. Unbiased next-generation sequencing may prove or rule out the existence of HCV-related viruses in IB indeterminate samples.
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Affiliation(s)
- J E Levi
- Hospital Israelita Albert Einstein Blood Bank, São Paulo, Brazil; Molecular Biology Department, Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, Brazil; Virology Lab, Instituto de Medicina Tropical, University of São Paulo, São Paulo, Brazil
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43
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Hosing C, Saliba RM, Hamerschlak N, Kutner JM, Sakashita AM, Kondo AT, Rodrigues M, Fernande JF, Chiattone A, Chiattone VC, Barros JC, Chiattone CS, Chiattone R, Popat U, Qazilbash M, Tang XW, Wu D, Majilis A, de Lima M, Anguita T. Peripheral blood stem cell yield calculated using preapheresis absolute CD34+ cell count, peripheral blood volume processed, and donor body weight accurately predicts actual yield at multiple centers. Transfusion 2014; 54:1081-7. [PMID: 24118027 DOI: 10.1111/trf.12435] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 07/18/2013] [Accepted: 07/22/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND Accurate prediction of stem cell yield is important for planning leukapheresis procedures. A formula has been published (Pierelli et al., Vox Sang 2006;91:126-34) to estimate the CD34+ dose collected on the first day of leukapheresis that was based on the preapheresis peripheral blood (PB) CD34+ counts, the blood volume processed, and the donor's weight. The aim of this study was to assess the predictive value of this formula. STUDY DESIGN AND METHODS Data were retrospectively collected on 1126 consecutive PB stem cell harvests conducted at five institutions. Information on age, sex, diagnosis, weight, preapheresis absolute peripheral CD34+ count, total blood volume processed, and CD34+ cells harvested per kilogram of body weight on the first day of apheresis was collected. RESULTS Among donors at least 18 years old, Pearson's correlation coefficient (r) between actual yield (AY) and predicted yield (PY) was 0.76. To characterize this correlation, AY and PY were classified as being within the conventionally acceptable CD34+ doses (>2 × 10(6) -5 × 10(6) cells/kg), below this range (≤2 × 10(6) cells/kg), or above it (>5 × 10(6) cells/kg). The positive predictive value (PPV) of PY was estimated considering the distribution of AY as the "gold standard." PPV was relatively high for PY of more than 5 × 10(6) cells/kg (85%), moderate for PY of not more than 2 × 10(6) cells/kg (72%), and low for PY more than 2 × 10(6) to 5 × 10(6) cells/kg (56%). A consistent pattern was observed within institutions. CONCLUSION The formula of Pierelli et al. is associated with a PPV that is high, moderate, and relatively low for the corresponding predicted CD34+ doses.
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Affiliation(s)
- Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Rodrigues M, Costa EM, de Moura Almeida A, Alves de Assis R, Cardoso Santos FN, Oliveira EA, da Cunha Pasqualin D, Bezerra AM, Esteves I, Barroso KS, Kerbauy FR, Kutner JM, Ribeiro AF, Sobrinho JJ, Torres M, Ganc A, Hamerschlak N. Endoscopy Biopsy in Different Sites for the Diagnosis of Lower and Upper Gastrointestinal Graft-Versus-Host Disease. Biol Blood Marrow Transplant 2014. [DOI: 10.1016/j.bbmt.2013.12.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mota M, Dezan M, Valgueiro MC, Sakashita AM, Kutner JM, Castilho L. RHD allelic identification among D-Brazilian blood donors as a routine test using pools of DNA. J Clin Lab Anal 2012; 26:104-8. [PMID: 22467325 DOI: 10.1002/jcla.21489] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND RHD alleles leading to a reduced expression of D antigen of the red blood cell (RBC) surface may be erroneously typed as D- by serology and may cause anti-D immunizations when transfused to recipients. METHODS To determine the occurrence of such alleles among apparent D- blood donors, molecular typing was implemented as a routine test using a pool of DNA. A total of 2,450 pretyped D- samples were tested in pools of 10 for the RHD-specific polymorphism in intron 4 and exon 7. Samples in polymer chain reaction (PCR) positive pools were individually reevaluated by exon-specific PCRs, sequencing, and serologic methods. RESULTS Among 2,450 serologically D- blood donor samples tested, 101 (4.1%) carried the RHD gene. Nonfunctional RHD (RHDψ, RHD*CE(2-9)-D, and RHD*CE(3-7)-D), different weak D alleles such as RHD*weak D type 1, RHD*weak D type 4.3, RHD*weak D type 5, RHD*weak D type 38, and RHD*DEL were identified. CONCLUSION We employed a PCR-based assay for RHD as a routine test using pools of ten DNA blood donor samples. The integration of RHD genotyping into the routine screening program using pools of DNA samples was straightforward. As a consequence, 19 (0.8%) blood donors carrying a weak D and Del phenotypes with the potential of causing anti-D immunizations in recipients were reclassified as D+. For each population, it would be necessary to adapt the RHD genotyping strategy to the spectrum of prevalent alleles.
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Affiliation(s)
- Mariza Mota
- Department of Hemotherapy, Albert Einstein Hospital, São Paulo, SP, Brazil.
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Fernandes JF, Kerbauy FR, Ribeiro AAF, Kutner JM, Camargo LFA, Stape A, Troster EJ, Zamperlini-Netto G, Azambuja AMPD, Carvalho B, Dorna MDB, Vilela MDS, Jacob CMA, Costa-Carvalho BT, Cunha JM, Carneiro-Sampaio MM, Hamerschlak N. Allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiencies: Hospital Israelita Albert Einstein experience. Einstein (Sao Paulo) 2011; 9:140-4. [PMID: 26760806 DOI: 10.1590/s1679-45082011ao2007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To report the experience of a tertiary care hospital with allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiencies. METHODS Seven pediatric patients with primary immunodeficiencies (severe combined immunodeficiency: n = 2; combined immunodeficiency: n = 1; chronic granulomatous disease: n = 1; hyper-IgM syndrome: n = 2; and IPEX syndrome: n = 1) who underwent eight hematopoietic stem cell transplants in a single center, from 2007 to 2010, were studied. RESULTS Two patients received transplants from HLA-identical siblings; the other six transplants were done with unrelated donors (bone marrow: n = 1; cord blood: n = 5). All patients had pre-existing infections before hematopoietic stem cell transplants. One patient received only anti-thymocyte globulin prior to transplant, three transplants were done with reduced intensity conditioning regimens and four transplants were done after myeloablative therapy. Two patients were not evaluated for engraftment due to early death. Three patients engrafted, two had primary graft failure and one received a second transplant with posterior engraftment. Two patients died of regimen related toxicity (hepatic sinusoidal obstruction syndrome); one patient died of progressive respiratory failure due to Parainfluenza infection present prior to transplant. Four patients are alive and well from 60 days to 14 months after transplant. CONCLUSION Patients' status prior to transplant is the most important risk factor on the outcome of hematopoietic stem cell transplants in the treatment of these diseases. Early diagnosis and the possibility of a faster referral of these patients for treatment in reference centers may substantially improve their survival and quality of life.
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Affiliation(s)
| | | | | | - Jose Mauro Kutner
- Blood Bank, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, BR
| | | | - Adalberto Stape
- Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, BR
| | | | | | | | - Bruna Carvalho
- Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, BR
| | - Mayra de Barros Dorna
- Children's Institute, Hospital da Clínicas of Medial College, Unversidade de São Paulo - USP, São Paulo, SP, BR
| | | | - Cristina Miuki Abe Jacob
- Children's Institute, Hospital da Clínicas of Medial College, Unversidade de São Paulo - USP, São Paulo, SP, BR
| | | | - Jose Marcos Cunha
- Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, BR
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Sakashita AM, Kondo AT, Ribeiro AAF, Cipolletta ANF, Colesanti MV, Hamerschlak N, Kutner JM. Factors affecting autologous peripheral blood hematopoietic stem cell collections by large-volume leukapheresis: a single center experience. Einstein (Sao Paulo) 2011; 9:196-200. [PMID: 26760815 DOI: 10.1590/s1679-45082011ao1932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate factors affecting peripheral blood hematopoietic stem cell yield in patients undergoing large-volume leukapheresis for autologous peripheral blood stem cell collection. METHODS Data from 304 consecutive autologous peripheral blood stem cell donors mobilized with hematopoietic growth factor (usually G-CSF), associated or not with chemotherapy, at Hospital Israelita Albert Einstein between February 1999 and June 2010 were retrospectively analyzed. The objective was to obtain at least 2 × 106 CD34+ cells/kg of body weight. Pre-mobilization factors analyzed included patient's age, gender and diagnosis. Post mobilization parameters evaluated were pre-apheresis peripheral white blood cell count, immature circulating cell count, mononuclear cell count, peripheral blood CD34+ cell count, platelet count, and hemoglobin level. The effect of pre and post-mobilization factors on hematopoietic stem cell collection yield was investigated using logistic regression analysis (univariate and multivariate approaches). RESULTS Pre-mobilization factors correlating to poor CD34 + cell yield in univariate analysis were acute myeloid leukemia (p = 0.017) and other hematological diseases (p = 0.023). Significant post-mobilization factors included peripheral blood immature circulating cells (p = 0.001), granulocytes (p = 0.002), hemoglobin level (p = 0.016), and CD34+ cell concentration (p < 0.001) in the first harvesting day. However, according to multivariate analysis, peripheral blood CD34+ cell content (p < 0.001) was the only independent factor that significantly correlated to poor hematopoietic stem cell yield. CONCLUSION In this study, peripheral blood CD34+ cell concentration was the only factor significantly correlated to yield in patients submitted to for autologous collection.
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Affiliation(s)
| | | | | | | | | | | | - Jose Mauro Kutner
- Blood Bank, Hospital Israelita Albert Einstein - HIAE, São Paulo, SP, BR
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Perini GF, Santos FPDS, Esteves I, Nascimento CMDBD, Rodrigues M, Assis RAD, Helman R, Kutner JM, Ribeiro AAF, Hamerschlak N. Use of gemtuzumab ozogamycin combined with conventional chemotherapy in patients with acute myeloid leukemia. Einstein (São Paulo) 2011; 9:190-5. [DOI: 10.1590/s1679-45082011ao1987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To analyze the outcome of patients treated with gemtuzumab ozogamycin combined with conventional therapy treated at Hospital Israelita Albert Einstein. Methods: 14 patients who had high risk features (secondary leukemia, unfavorable cytogenetics, and refractory disease) were treated with gemtuzumab ozogamycin combined with conventional therapy and their outcome was analysed by reviewing their medical records. Results: Overall response rate was 58%, with 43% achieving complete response, with a median follow-up of 11 months, event-free survival was 3 months. Eleven patients died, 6 of them due to refractory acute myeloid leukemia. Only four patients presented with grade 3 to 4 toxicities and only one patient had sinusoidal obstruction syndrome after bone marrow transplant. Conclusion: gemtuzumab ozogamycin combined with chemotherapy is a feasible treatment regimen in acute myeloid leukemia patients. However, further studies are necessary to clarify which subgroup of patients may beneft from this treatment.
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Hamerschlak N, Rodrigues M, Moraes DA, Oliveira MC, Stracieri ABPL, Pieroni F, Barros GMN, Madeira MIA, Simões BP, Barreira AA, Brum DG, Ribeiro AAF, Kutner JM, Tylberi CP, Porto PP, Santana CL, Neto JZ, Barros JC, Paes AT, Burt RK, Oliveira EA, Mastropietro AP, Santos AC, Voltarelli JC. Brazilian experience with two conditioning regimens in patients with multiple sclerosis: BEAM/horse ATG and CY/rabbit ATG. Bone Marrow Transplant 2009; 45:239-48. [DOI: 10.1038/bmt.2009.127] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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50
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Mota M, Bley C, Aravechia MG, Hamerschlak N, Sakashita A, Kutner JM, Castiho L. Autoantibody formation after alloimmunization inducing bystander immune hemolysis. Immunohematology 2009; 25:9-12. [PMID: 19856726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The development of RBC autoantibodies resulting from or associated with allogeneic blood transfusions is not an easily determined complication of RBC transfusions. This report discusses one patient who developed RBC autoantibodies in association with an allogeneic blood transfusion and alloimmunization leading to a temporary bystander immune hemolysis. A 72-year-old woman was hospitalized as a result of severe anemia and received two units of ABO- and D-compatible RBCs. She had a history of two pregnancies 40 years before, but no history of RBC transfusion, and her antibody screen was negative. On the tenth day after transfusion her hemoglobin dropped, and alloanti-c was identified in her serum and eluate. At this time she received another two units of compatible blood according to her phenotype (group O, R1R1, K:-1). After 48 hours, she developed joint pain, pyrexia, and hemoglobinuria, and her Hb dropped from 9.2 g/dL to 5.3 g/ dL. The direct antiglobulin test was positive, an IgG autoantibody was present in the eluate, and the antibody investigation revealed the presence of anti-Jk(b) in addition to the previously identified alloanti-c. Her genotype was determined, and, based on the findings, two additional units were selected, found to be compatible, and transfused without incident. Transfusions were discontinued, and she was treated with IVIG and corticosteroids. Her Hb increased to 9.7 g/dL, and the patient made an uneventful recovery. It was concluded that transfusion of incompatible RBCs induced the formation of an autoantibody in this patient, resulting in lysis of bystander RBCs. The need for additional blood transfusion was successfully avoided by treatment with IVIG, steroid therapy, and rituximab.
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Affiliation(s)
- M Mota
- Departamento de Hemoterapia, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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