Correlation between the Severity of Bone Pain and the Amount of CD34+ Cells after Peripheral Blood Stem Cell Mobilization / 대한수혈학회지

BACKGROUND: Peripheral blood stem cells (PBSCs) are mobilized by granulocyte-colony stimulating factor (G-CSF), which causes several side effects in allogeneic donors. We report on side effects of G-CSF administration and determine which side effects could be used in predicting the amount of harvested CD34+ cells. METHODS: Data from the first PBSC collections of 155 healthy donors between 2007 and 2010 were analyzed. Side effects were assessed using adverse event inventory, which was graded from 1 (mild) to 3 (severe) or 4 (disabling). RESULTS: G-CSF administration caused an elevation of WBC counts (mean 44,834/microL) and 86% of them were neutrophils. The mean mononuclear cells in apheresis products was 6.6x10(8)/kg and mean CD34+ cells was 6.0x10(6)/kg. Bone pain was reported by 151 healthy donors (97%) and severe bone pain was related to more CD34+ cells in apheresis products (P=0.041): 39 for grade 1 (5.1x10(6) CD34+cells/kg), 86 for grade 2 (6.0x10(6)), and 26 for grade 3 (7.1x10(6)). In addition, the percentage of collecting more than 5.0x10(6) CD34+cells/kg during the first leukapheresis showed correlation with the severity of bone pain. CONCLUSION: Bone pain was the most common side effect of G-CSF mobilization and more CD34+ cells were harvested in cases of severe bone pain.

A Case of Delayed Hemolytic Transfusion Reaction due to Anti-N / 대한수혈학회지

No abstract available.

Comparison of Cryopreservation Methods of Rare Red Blood Cells Used for Antibody Identification Tests / 대한수혈학회지

BACKGROUND: When a certain antibody, which is not clearly identified, is detected before transfusion, rare red blood cells (RBCs) should be used for antibody identification. But its rarity make it difficult to identify the antibody. This study compared the high glycerol method with the liquid nitrogen method for the cryopreservation of rare RBCs that are used for antibody identification. METHODS: The frozen RBCs were thawed every 2 months to measure the strength of agglutination. We observed the changes of the strength of agglutination. The Di(a) antigen, which is relatively frequent in Asians, was included in this study. RESULTS: Using the high glycerol method, the decrease of the strength of agglutination was observed with using the k antigen from 4 months and the decrease of the strength of agglutination was observed with using M, N, s, Le(a), Le(b) and Fy(b) antigens from 8 months. With freezing the donor RBCs by the liquid nitrogen method, the decrease of the strength of agglutination was observed with using the C, s, k and Le(b) antigens from 2 months, with using the M and S antigens from 4 months, with using the D, c, e, N and Fy(a) antigens from 6 months and with using the Le(a) antigen from 8 months. Rare RBCs with the Di(a) antigen were successfully cryopreserved for 6 months with using the high glycerol method. For the commercial screening cells, the high glycerol method showed effective cryopreservation with using c, e, M, k, Le(a), Le(b), Jk(a) and Fy(b) antigens for 6 months or longer. CONCLUSION: We were able to preserve most of the important antigens of the RBCs for at least 6 months without a significant decrease of reactivity by employing the high glycerol cryopreservation technique.

Comparison of Cryopreservation Methods of Rare Red Blood Cells Used for Antibody Identification Tests / 대한수혈학회지

BACKGROUND: When a certain antibody, which is not clearly identified, is detected before transfusion, rare red blood cells (RBCs) should be used for antibody identification. But its rarity make it difficult to identify the antibody. This study compared the high glycerol method with the liquid nitrogen method for the cryopreservation of rare RBCs that are used for antibody identification. METHODS: The frozen RBCs were thawed every 2 months to measure the strength of agglutination. We observed the changes of the strength of agglutination. The Di(a) antigen, which is relatively frequent in Asians, was included in this study. RESULTS: Using the high glycerol method, the decrease of the strength of agglutination was observed with using the k antigen from 4 months and the decrease of the strength of agglutination was observed with using M, N, s, Le(a), Le(b) and Fy(b) antigens from 8 months. With freezing the donor RBCs by the liquid nitrogen method, the decrease of the strength of agglutination was observed with using the C, s, k and Le(b) antigens from 2 months, with using the M and S antigens from 4 months, with using the D, c, e, N and Fy(a) antigens from 6 months and with using the Le(a) antigen from 8 months. Rare RBCs with the Di(a) antigen were successfully cryopreserved for 6 months with using the high glycerol method. For the commercial screening cells, the high glycerol method showed effective cryopreservation with using c, e, M, k, Le(a), Le(b), Jk(a) and Fy(b) antigens for 6 months or longer. CONCLUSION: We were able to preserve most of the important antigens of the RBCs for at least 6 months without a significant decrease of reactivity by employing the high glycerol cryopreservation technique.

Clinical Usefulness of Plasma Interleukin-6 and Interleukin-10 in Disseminated Intravascular Coagulation / 대한진단검사의학회지

BACKGROUND: Disseminated intravascular coagulation (DIC) is a syndrome characterized by a systemic activation of coagulation leading to the intravascular deposition of fibrin and the simultaneous consumption of coagulation factors and platelets. Inflammatory cytokines can activate the coagulation system. This study investigated the diagnostic and prognostic usefulness of the plasma level of interleukin-6 (IL-6) and interleukin-10 (IL-10) for predicting DIC. METHODS: The study populations were 15 healthy controls and 81 patients who were clinically suspected of having DIC and were requested to perform DIC battery tests. The presence of overt DIC was defined by the International Society on Thrombosis and Haemostasis Subcommittee cumulative score of 5 or above. The 28 day mortality was used to assess the prognostic outcome. The plasma levels of the cytokines were measured by ELISA. RESULTS: The plasma levels of IL-6 and IL-10 in patients (N=81) were higher than those of control (N=15). IL-6 and IL-10 levels of overt DIC group (N=31) were 3 times and 1.5 times higher than those, respectively, of non-overt DIC group (N=50). In infection group (N=48), IL-6 and IL-10 levels of overt DIC group (N=18) were 5 times and 3 times higher than those, respectively, of non-overt DIC group (N=30). The diagnostic efficiency of IL-6 (optimal cut off >40.4 pg/mL) and IL-10 (>9.7 pg/mL) for the diagnosis of overt DIC were 67% and 69%, respectively, which were similar to that of D-dimer. Plasma levels of IL-6 and IL-10 were also higher in non-survivors than in survivors. The patients with higher levels of IL-6 and IL-10 showed a poorer prognosis. CONCLUSIONS: The proinflammatory cytokine, IL-6 and anti-inflammatory cytokine, IL-10 were useful for the diagnosis of overt DIC and the prediction of its prognosis. These results also showed the evidence of a close interaction between coagulation and inflammation.

A Case of Transfusion-related Acute Lung Injury / 대한수혈학회지

Transfusion-related acute lung injury (TRALI) is defined as a new episode of acute lung injury that occurs during or within 6 hours of a completed transfusion, which has been the leading cause of transfusion-related death. We report a case of TRALI in a 63-year old man with alcoholic liver disease. He developed hypoxemia and non-cardiogenic pulmonary edema after red blood cell transfusion. Given an oxygen support, he recovered after 4 days.