Thrombocytopenia Experienced by Healthy Peripheral Blood Stem Cell Donors at a Tertiary Hospital in Korea / 대한수혈학회지

In healthy peripheral blood stem cell (PBSC) donors, rare cases of transient thrombocytopenia have been reported due to the administration of granulocyte colony-stimulating factor (G-CSF) or the apheresis itself. Meanwhile, differentiating pseudothrombocytopenia induced by anticoagulants is crucial, as it can result in false low platelet counts. This study aimed to investigate the causes of thrombocytopenia in healthy PBSC donors. We investigated PBSC donors who experienced thrombocytopenia during transplantation at St. Mary’s Hospital, Seoul. Three donors were identified and donor workup studies were within the normal limits. After G-CSF administration prior to transplantation, the donors experienced a significant reduction in platelet counts. Apheresis resulted in lower levels, yet platelet counts returned to normal levels approximately two weeks later. In donor 3, thrombocytopenia was seen during the donor workup and ethylenediaminetetraacetic acid (EDTA)-induced pseudothrombocytopenia was identified after the supplementation of amikacin. For donor 3, we investigated whether his recipient’s sample showed EDTA-induced pseudothrombocytopenia through a review of any platelet clumping in the apheresis product and the presence of immunoglobulin M (IgM) or IgG antiplatelet antibodies in the recipient’s peripheral blood. In conclusion, the risk of severe thrombocytopenia with G-CSF administration in PBSC donors should be considered and accurate differentiation of pseudothrombocytopenia is imperative.

Transfusion support in hematopoietic stem cell transplantation

Transfusion support for hematopoietic stem cell transplantation (HSCT) is an essential part of supportive care, and compatible blood should be transfused into recipients. As leukocyte antigen (HLA) matching is considered first and as the blood group does not impede HSCT, major, minor, bidirectional, and RhD incompatibilities occur that might hinder transfusion and cause adverse events. Leukocyte reduction in blood products is frequently used, and irradiation should be performed for blood products, except for plasma. To mitigate incompatibility and adverse events, local transfusion guidelines, hospital transfusion committees, and patient management should be considered.

Effect of Modafinil and Methylphenidate on Sleep-Wake Architecture and EEG Power Spectra in Rats / 대한정신약물학회지

OBJECTIVE : Modafinil, methylphenidate, and caffeine are wakefulness-promoting substances. Previously, it was reported that caffeine-induced wakefulness differs from natural wakefulness in terms of the EEG spectral profiles. In order to evaluate whether wakefulness induced by other psychostimulants differs from both caffeine-induced and natural wakefulness, we examined the effects of the psychostimulants on sleep-wake architecture and EEG spectral profiles. METHODS : Eighteen Sprague-Dawley male rats underwent an EEG/EMG recording session from 10 : 30 to 17 : 30. They received caffeine (7.5, 15, 30 mg/kg i.p.), methylphenidate (1, 2, 5, 10 mg/kg i.p.) or modafinil (5, 10, 25, 50, 100 mg/kg i.p.) at 13 : 30. The number, total duration, and average duration of sleepwake states were obtained. EEG band powers were calculated by spectral analysis. Frequency bands were divided into the following ranges : D1, 1-2.5 Hz ; D2, 2.5-4.5 Hz ; T1, 4.5-7 Hz ; T2, 7-10 Hz ; SI, 10-14 Hz ; B1, 14-22 Hz ; B2, 22-34 Hz ; GA, 34-50 Hz. RESULTS : All three psychostimulants significantly and dose-dependently increased active wake duration and decreased slow-wave sleep. Equipotent doses of caffeine, methylphenidate, and modafinil for increasing active wake and decreasing slow-wave sleep were 7.5 mg/kg, 10 mg/kg, and 100 mg/kg, respectively. In equipotent doses, an increase of active wake duration by caffeine and methylphenidate was attributed to increases of both frequency and average duration of active wake state, whereas increase of active wake duration by modafinil was attributed to increase of average duration of active wake state only. In equipotent doses, caffeine and methylphenidate decreased the power of lower frequency bands (1-22 Hz), whereas modafinil did not. During slow-wave sleep, modafinil and methylphenidate increased the power of lower frequency bands, but caffeine did not. All the psychostimulants increased the power of the GA band, which was more prominent in the frontal cortex than the parietal cortex. CONCLUSION : These results suggest that moda-nil-induced wakefulness differs from caffeine- or methylphenidate-induced wakefulness in terms of EEG spectral profiles and sleep-wake architecture.