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1.
Bone Marrow Transplant ; 47(12): 1564-8, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22609881

RESUMO

The correlation between the incidence of GVHD and the number of infused CD34(+) cells remains controversial for PBSC transplantation after a reduced-intensity-conditioning (RIC) regimen. We evaluated 99 patients transplanted with an HLA-identical sibling after the same RIC (2-Gy-TBI/fludarabine). Donor and recipient characteristics, donor's blood G-CSF-mobilized CD34(+) cell count, and number of infused CD34(+) and CD3(+) cells were analyzed as risk factors for acute and chronic GVHD There was a trend for an increased incidence of extensive chronic GVHD in the quartile of patients receiving more than 10 × 10(6) CD34(+) cells/kg (P = 0.05). Interestingly, the number of donor's blood CD34(+) cells at day 5 of G-CSF mobilization was closely associated with the incidence of extensive chronic GVHD, that is, 48% (95% CI: 28-68) at 24-months in the quartile of patients whose donors had the highest CD34(+) cell counts versus 24.3% (95% CI: 14-34) in the other patients (P = 0.007). In multivariate analysis, the only factor correlating with extensive chronic GVHD (cGVHD) was the donor's blood CD34(+) cell count after G-CSF (HR 2.49; 95% CI: 1.16-5.35, P = 0.019). This study shows that the incidence of cGVHD is more strongly associated with the donor's ability to mobilize CD34(+) cells than with the number of infused CD34(+) cells.


Assuntos
Antígenos CD34/imunologia , Doença Enxerto-Hospedeiro/imunologia , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Mobilização de Células-Tronco Hematopoéticas/métodos , Transplante de Células-Tronco de Sangue Periférico/métodos , Adulto , Idoso , Antígenos CD34/sangue , Doença Crônica , Doença Enxerto-Hospedeiro/sangue , Células-Tronco Hematopoéticas/metabolismo , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante Homólogo , Adulto Jovem
2.
Transfus Clin Biol ; 17(2): 41-6, 2010 Apr.
Artigo em Francês | MEDLINE | ID: mdl-20674441

RESUMO

PURPOSE: Today, haematopoietic stem cell graft from placental blood concerns more than 15 % of allogeneic grafts. An inter-laboratory study of the quality control of defrosted cord blood units has been coordinated by the French society for cell and tissue bioengineering (SFBCT), with the cord blood bank of Bourgogne Franche-Comté and controlled by the French health products safety agency (Afssaps). The aim of this study is to ensure the inter-laboratory reproducibility of the quality controls practised by the banks during defrosting. The cellular outputs were analyzed according to the defrosting techniques, according to the method used in flow cytometry: single-platform (SP) versus double-platform (DP), or the product nature, i.e. in total blood or miniaturized. METHODS: Forty-two units of placental blood (USP), which were out of range were provided for defrosting to 14 participating sites. USP were defrosted and controlled according to the procedures of each bank. Once the USP is defrosted, a part of the product was controlled by the site and the other part by Afssaps. Following controls were carried out: numeration of the total nucleated cells (TNC) and of CD34+ cells (made by a SP method in Afssaps) and functional assay. RESULTS: Concerning TNC, the defrosting sites obtained a cellular output of 94 %+/-28 in day 0 compared with an output of 72 %+/-24 in Afssaps showing a rather good stability of the USP transmitted with an average deviation of 23 %+/-22. The freezing process with or without reduction of volume does not affect this variation. Concerning the numeration of CD34+ cells, the average deviation between the participating sites and Afssaps was 29 %+/-23 compared with 21 %+/-16 for the sites using a SP method against 47 %+/-25 for those using a DP method. The CD34+ outputs are equal to 82 % +/- 60 in day 0 for the participating sites against 52 %+/-20 for Afssaps. For the sites using a DP method, it is stressed that this output is particularly high with a rate of 126 %+/-90 (n=15) whereas it is 62 %+/-20 (n=32) for the sites using a SP method. CONCLUSION: These results underline a good stability of viable CD34+ cells and a greater reliability of the SP methods for the CD34+ cell numeration for these defrosted USP. Lastly, the results of the functional assay regarding the average clonogenicities (equal to 15 %) reinforce the conclusions on the quality of the defrosted products.


Assuntos
Preservação de Sangue/normas , Transplante de Células-Tronco de Sangue do Cordão Umbilical/normas , Criopreservação/normas , Sangue Fetal , Controle de Qualidade , Antígenos CD34/análise , Contagem de Células Sanguíneas , Preservação de Sangue/métodos , Núcleo Celular/ultraestrutura , Células Clonais/citologia , Ensaio de Unidades Formadoras de Colônias , Feminino , França , Células-Tronco Hematopoéticas/ultraestrutura , Humanos , Recém-Nascido , Laboratórios , Placenta , Gravidez , Sociedades Médicas/normas
3.
Bone Marrow Transplant ; 35(9): 903-7, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15765111

RESUMO

To decrease red blood cell (RBC) transfusion requirements during high-dose therapy (HDT) for hematological malignancies, we conducted a pilot study to assess the effect of recombinant human erythropoietin (rHuEpo) given during chemotherapy before HDT and autologous peripheral stem-cell transplantation (APSCT). The transfusion histories of 15 HDT and APSCT for hematological disease performed in 11 consecutive patients who received rHuEpo (10 000 U subcutaneously three times/week) were compared to those of 22 HDT and ASCT performed in 17 consecutive historical controls matched for hematological parameters. rHuEpo increased the hemoglobin (Hb) level from 10.3+/-2.3 g/dl at diagnosis to 12.9+/-2.2 g/dl at the time of HDT in 11 patients; no major adverse effects occurred. Compared to historical controls (95%, 21/22), RBC transfusion requirements were significantly lower for rHuEpo recipients (26%, 4/15) (P=0.00001) and rHuEpo responders (15%, 2/13) (P=0.000002). After HDT and APSCT, fewer RBC transfusions were needed: 3.3, 1.2 and 0.3 RBC units for controls, rHuEpo recipients and rHuEpo responders, respectively (P=0.006 and 0.00002). Therefore, rHuEpo should be administered before, and not after HDT and APSCT, to lower RBC transfusion requirements after HDT and APSCT.


Assuntos
Transfusão de Eritrócitos , Eritropoetina/administração & dosagem , Linfoma de Célula do Manto/terapia , Mieloma Múltiplo/terapia , Transplante de Células-Tronco de Sangue Periférico , Adulto , Idoso , Humanos , Linfoma de Célula do Manto/sangue , Pessoa de Meia-Idade , Mieloma Múltiplo/sangue , Projetos Piloto , Proteínas Recombinantes , Transplante Autólogo
4.
Ann Hematol ; 80(11): 639-46, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11757722

RESUMO

CD34+ cell counts in peripheral blood (PB) and corresponding numbers of CD34+ cells and colony-forming units-granulocyte/macrophage (CFU-GM) in 299 leukapheresis products of 209 patients undergoing PB progenitor cell (PBPC) mobilization for autologous transplantation in two different centers were analyzed and compared according to diagnosis: non-Hodgkin lymphoma (NHL, 94 leukaphereses), multiple myeloma (MM, 75), Hodgkin's disease (HD, 37), solid tumors (35), and chronic myeloid leukemia (CML, 32). Without separating disease entities, correlations between PB CD34+ cell counts and leukapheresis content of CD34+ cells (r>0.83, P<0.01) and CFU-GM (r>0.81, P<0.01) were excellent. In both centers, a PB CD34 threshold ensuring a leukapheresis yield > 10(6) CD34/kg was determined. This threshold was higher in center 1 than in center 2, and its predictive accuracy (91.4%, i.e., prediction correct 91.4% of the time) was significantly lower than in center 2 (98.4%, P=0.02). When data were analyzed by pathology, PB CD34+ cell counts and leukapheresis content of CD34+ cells and CFU-GM remained well correlated, and in both centers PB CD34 thresholds predictive of a yield > 10(6) CD34/kg per leukapheresis could be determined for each pathology. For most patients, pathology-specific PB CD34 thresholds could be obtained directly from the equation of the PB CD34/leukapheresis CD34 correlation curve; they varied depending on both pathology and center (range: 7-20 x 10(6) CD34/l). Pathology-specific thresholds predicted a leukapheresis yield > or = 10(6) CD34/kg accurately 100% of the time for MM patients in center 2 and HD and solid tumor patients of both centers, resulting in overall rates of accurate prediction of sufficient graft CD34 content of 96.6% in center 1 and 98.9% in center 2.


Assuntos
Antígenos CD34/análise , Células Sanguíneas/transplante , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Leucaférese/métodos , Adolescente , Adulto , Idoso , Células Sanguíneas/química , Células Cultivadas , Criança , Pré-Escolar , Ensaio de Unidades Formadoras de Colônias , Feminino , Previsões , Neoplasias Hematológicas/sangue , Neoplasias Hematológicas/patologia , Células-Tronco Hematopoéticas/química , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/sangue , Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/terapia , Linfoma/sangue , Linfoma/patologia , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Células Progenitoras Mieloides/fisiologia , Neoplasias/sangue , Neoplasias/patologia , Neoplasias/terapia , Sensibilidade e Especificidade
5.
Ann Vasc Surg ; 10(3): 292-6, 1996 May.
Artigo em Inglês | MEDLINE | ID: mdl-8792999

RESUMO

We report a case of aortoesophageal fistula occurring as a complication of colonic esophagoplasty. Emergency treatment during the hemorrhagic phase combined aortic replacement using a cryopreserved arterial allograft and digestive tract exclusion. Immediate recovery and follow-up at 8 months were good. This is the first reported case of successful in situ aortic replacement using a cryopreserved allograft for an aortoesophageal fistula. The lack of previous reports of successful treatment and related treatment modalities are discussed.


Assuntos
Doenças da Aorta/cirurgia , Artérias/transplante , Criopreservação , Fístula Esofágica/cirurgia , Fístula/cirurgia , Adulto , Aorta Torácica , Doenças da Aorta/etiologia , Fístula Esofágica/etiologia , Esofagoplastia/efeitos adversos , Fístula/etiologia , Humanos , Masculino
6.
Allerg Immunol (Paris) ; 19(4): 128-34, 1987 Apr.
Artigo em Francês | MEDLINE | ID: mdl-3453128

RESUMO

Frequent allergic reactions following transfusion are observed. Usually, they are benign but sometimes we observe severe allergic reactions. Adverse reactions may be brought about by least two mechanisms. First, immediate-type hypersensibility reactions due to IgE. Secondly, anaphylactic-type reactions due to interaction between transfused IgA and class specific anti IgA in the recipient's plasma. They are characterized by their severest form (anaphylactic shock). The frequency of severe reactions following the transfusion blood plasma is very low. These transfusion reactions are complement-mediated and kinins-mediated. Prevention of allergic reactions is necessary among blood donors and recipients.


Assuntos
Anafilaxia/imunologia , Hipersensibilidade Imediata/prevenção & controle , Reação Transfusional , Anafilaxia/prevenção & controle , Doadores de Sangue , Proteínas do Sistema Complemento/imunologia , Humanos , Hipersensibilidade Imediata/imunologia , Imunoglobulina A/imunologia , Imunoglobulina E/imunologia , Cininas/imunologia
7.
Rev Fr Transfus Immunohematol ; 28(4): 317-24, 1985 Sep.
Artigo em Francês | MEDLINE | ID: mdl-4081508

RESUMO

The technical parameters of blood filtration through cotton Imugard IG 500 filters were evaluated. Sixty units of red cell concentrates were filtered. The mean value of the residual leukocytes indicated a leukocyte depletion greater than 98%, disregarding the unit age and the filtration temperature. The number of residual leukocytes was below 1 X 10(8) in 94% of the filtered units and less than 0.3 X 10(8) in 68%. The number of residual platelets was less than 1 X 10(10) in 92% of these units.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Eritrócitos/citologia , Leucócitos/citologia , Plaquetas/citologia , Filtração , Gossypium , Humanos
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