Stored red blood cell viability is maintained after treatment with a second-generation S-303 pathogen inactivation process.

BACKGROUND: Transfusion-transmitted infections and immunologic effects of viable residual lymphocytes remain a concern in red blood cell (RBC) transfusion. Pathogen reduction technologies for RBC components are under development to further improve transfusion safety. S-303 is a frangible anchor-linker-effector with labile alkylating activity and a robust pathogen reduction profile. This study characterized the viability of RBCs prepared with a second-generation S-303 process and stored for 35 days. STUDY DESIGN AND METHODS: This was a two-center, single-blind randomized, controlled, crossover study in 27 healthy subjects. S-303 (test) or control RBCs were prepared in random sequence and stored for 35 days, at which time an aliquot of radiolabeled RBCs was transfused. The 24-hour recovery, RBC life span, and in vitro metabolic and viability variables were analyzed. RESULTS: The mean 24-hour RBC recovery and hemolysis of test RBCs were similar to control RBCs and were consistent with the Food and Drug Administration (FDA) guidance for RBC viability. The mean differences in life span and median life span (T(50) ) of circulating test RBCs were 13.7 and 6.8 days, while the mean difference in the area under the curve of surviving RBCs was 1.38%, in favor of control RBCs. There were no clinically relevant abnormal laboratory values after the infusion of test RBCs. All crossmatch assays of autologous S-303 RBCs were nonreactive. CONCLUSIONS: RBCs prepared using the S-303 pathogen inactivation process were physiologically and metabolically suitable for transfusion after 35 days of storage, met the FDA guidance criteria for 24-hour recovery, and did not induce antibody formation.

Determination of acute lung injury after repeated platelet transfusions.

Acute lung injury (ALI) during hematopoietic stem cell transplant (HSCT) is associated with substantial morbidity; however, the frequency of ALI in HSCT patients is poorly characterized. Platelets are postulated to play a critical role in the pathogenesis of ALI. Using a transfusion trial of pathogen inactivated platelet components (PC-Test) compared with conventional PC (Reference) populated with HSCT patients, data were reviewed by an adjudication panel to determine the frequency of ALI overall, by treatment groups, and key outcomes: PC exposure, ventilator-free days, and mortality. The diagnosis of ALI was based on American European Consensus Criteria. Of 645 patients who received PC over 28 days, 100 (15.5%) had clinically serious pulmonary adverse events, and 35 (5.4%) met criteria for ALI. Days of platelet support and number of platelet transfusions for patients with ALI were not significantly different from patients without ALI (P > .05). Mortality was greater for patients with ALI (57%) than those without (17%, P < .001) but not significantly different between treatment groups. For patients with ALI, the distributions of time to onset of mechanical ventilation were significantly different (P = .04). Patients supported with Reference PC were more likely to be ventilated sooner than patients receiving Test PC.

Cancer mortality in a Chinese population exposed to hexavalent chromium in drinking water.

BACKGROUND: In 1987, investigators in Liaoning Province, China, reported that mortality rates for all cancer, stomach cancer, and lung cancer in 1970-1978 were higher in villages with hexavalent chromium (Cr+6)-contaminated drinking water than in the general population. The investigators reported rates, but did not report statistical measures of association or precision. METHODS: Using reports and other communications from investigators at the local Jinzhou Health and Anti-Epidemic Station, we obtained data on Cr+6 contamination of groundwater and cancer mortality in 9 study regions near a ferrochromium factory. We estimated: (1) person-years at risk in the study regions, based on census and population growth rate data, (2) mortality counts, based on estimated person-years at risk and previously reported mortality rates, and (3) rate ratios and 95% confidence intervals. RESULTS: The all-cancer mortality rate in the combined 5 study regions with Cr+6-contaminated water was negligibly elevated in comparison with the rate in the 4 combined study regions without contaminated water (rate ratio = 1.13; 95% confidence interval = 0.86-1.46), but was somewhat more elevated in comparison with the whole province (1.23; 0.97-1.53). Stomach cancer mortality in the regions with contaminated water was more substantially elevated in comparison with the regions without contaminated water (1.82; 1.11-2.91) and the whole province (1.69; 1.12-2.44). Lung cancer mortality was slightly elevated in comparison with the unexposed study regions (1.15; 0.62-2.07), and more strongly elevated in comparison with the whole province (1.78; 1.03-2.87). Mortality from other cancers combined was not elevated in comparison with either the unexposed study regions (0.86; 0.53-1.36) or the whole province (0.92; 0.58-1.38). CONCLUSIONS: While these data are limited, they are consistent with increased stomach cancer risk in a population exposed to Crz=6 in drinking water.