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Biomedical subjects

F Norol

Publications and source records attributed to F Norol.

34 records · Page 2Linked to original sources
PubMed1994

[Transfusion and alloimmunization in sickle cell anemia patients].

Transfusion therapy for sickle cell anemia is limited by the development of antibodies to red cell antigens. The aim of this study was to evaluate whether transfusion of blood matched for antigens Rh and Kell would reduce the incidence of alloimmunization. We determined the transfusion history, red cell phenotype and development of alloantibodies in 173 patients with sickle all anemia who received transfusions. Forty nine patients were transfused exclusively with frozen red blood cells (RBL) matched for antigens Rh and Kell; the rate of alloimmunization was 8.2%; antibodies to the Jkb, Jka, Fya and S were developed; 1 patient developed 2 antibodies. In a control group of 124 patients who received standard red blood cells, the rate of alloimmunization was significantly increased to 30.6% (p < 0.05); antibodies against C, E, K, Fya were the most frequently developed and 19 patients (16%) developed antibodies reacting with different antigens. In the 2 groups, alloimmunization occurred after receiving a significantly different number of transfusions: mean 9 in the patients transfused with matched RBC and 32 in the control group. The influence of the kinetics of transfusion was not demonstrated. To assess the effect that racial differences might have on alloimmunization, comparison of the red cell phenotype of patients with that of a panel of unselected blood bank donors was performed: the patients had a significant decrease in the frequency of red cell antigens corresponding to most of the detected alloantibodies JkB, C, S. Fyb, Fya and Kell.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Hepatitis C virus infection and allogeneic bone marrow transplantation.

Serum antibodies to hepatitis C virus (HCV) were tested for inpatients undergoing allogeneic BMT to determine the risk of acquiring HCV infection and the role of HCV in posttransplant liver complications. The HCV seroconversion rate was evaluated according to the date of BMT and blood donor screening at the time. Anti-HCV antibodies (anti-HCV) were detected with a second-generation ELISA and confirmed with a second-generation radioimmunoblot assay. All patients received leukocyte-depleted blood products and most received apheresis platelet concentrates. One hundred twenty of 181 consecutive patients transplanted from January 1987 to December 1991 were anti-HCV-negative before BMT, had at least 6 months of follow-up, and were thus evaluated for the seroconversion rate. Before screening for non-A, non-B hepatitis, 14% of the patients seroconverted to HCV (0.44% per unit transfused). After introduction of screening for alanine aminotransferase and antibodies to hepatitis B core antigen the risk of seroconversion was 4% per patient (0.26% per unit). When, in addition, blood was screened for anti-HCV the risk fell to 1.6% (0.03% per unit). Positive anti-HCV status before and after BMT was not predictive of veno-occlusive disease, liver graft-versus-host disease (GVHD), or death due to liver dysfunction. In contrast, the risk of chronic hepatitis was significantly increased.

Adolescent↗
PubMed1994

Influence of clinical status on the efficiency of stored platelet transfusion.

The efficiency of stored platelet transfusion was evaluated in terms of clinical status in 141 thrombocytopenic patients. In a paired prospective study in which fresh platelets were used as controls, clinical efficiency was assessed on the basis of the ability to increase platelet count (recovery) and the time to the next transfusion (D). In 48 clinically stable patients, recovery of fresh and stored platelets was similar (47% and 41%, respectively) and the interval to the next transfusion was D4 and D3. In contrast, 27 patients who had bacterial infections showed significantly different recoveries (24%/5%) and the interval to the next transfusion was D3/D1 for fresh and stored platelets respectively. Similarly, in 16 patients who were treated concurrently with amphotericin B, 18 other patients with graft-versus-host disease, nine with splenomegaly and four with veno-occlusive disease (VOD), fresh platelets performed better than stored platelets, showing recoveries of 27%/18%, 29%/15%, 16%/3% and 15%/2%. Furthermore, the need for retransfusion within 24 h was significantly increased with stored platelets. In 19 patients with anti-HLA alloimmunization who were transfused with HLA-matched fresh and stored apheresis platelet concentrate (APC), efficiency was similar (38%/36% and D4/D3). This study indicates that the storage induces an impressive decrease in the in-vivo platelet recovery and survival in patients with certain clinical conditions.

Adult↗
PubMed1994

Comparison of autografting using mobilized peripheral blood stem cells with and without granulocyte colony-stimulating factor in malignant lymphomas.

Peripheral blood is becoming widely used as the only source of hematopoietic stem cells to support marrow ablative therapy in advanced lymphoma. We report data from 23 patients with high risk non-Hodgkin's (n = 19) and Hodgkin's lymphoma (n = 4) who underwent high-dose therapy with mobilized peripheral blood stem cell (PBSC) autografting. Peripheral blood progenitors were recruited using cytotoxic chemotherapy followed by administration of recombinant human G-CSF (filgrastim 5 micrograms/kg/day). Myeloablative treatment with autologous PBSC support was administrated to the 23 patients and followed by G-CSF at the same dose after cell reinjection. Hematopoietic reconstitution was compared with a control group of lymphoma patients who received chemotherapy mobilized PBSC transplantation but without G-CSF prior to leukaphereses or after high-dose therapy. The median time to neutrophil recovery > 0.5 x 10(9)/l was significantly shorter in study patients compared with the control patients (10 days and 17 days respectively) (p < 0.05). Self sustaining platelet counts of > 50 x 10(9)/l occurred at a median time of 17 days in both groups. Stable hemopoietic reconstitution was seen with a follow-up of 6 months after PBSC transplantation. In addition, a significant relationship was observed between the number of CFU-GM infused and the time to platelet recovery. We confirm the effectiveness of G-CSF given prior to PBSC harvesting in generating high numbers of progenitor cells. Hematologic recovery following high-dose therapy was improved after PBSC rescue and G-CSF.

Adolescent↗
PubMed1993

[Influence of clinical status on the efficacy of stored platelet transfusion].

The efficiency of stored platelet transfusion was evaluated in terms of clinical status in 136 thrombocytopenic patients. In a paired prospective study in which fresh platelets were used as controls, clinical efficiency was assessed on the basis of the ability to increase platelet count (recovery) and the interval to the next transfusion (D). In 48 clinically stable patients, recovery of fresh and stored platelets was similar (47% and 41% respectively) and the interval to the next transfusion was D4 and D3. In contrast, 27 patients who had bacterial infections showed significantly different recoveries (24%/5%) and the interval to the next transfusion was D3/D1 for fresh and stored platelets respectively. Similarly, in 16 patients who were treated concurrently with Amphotericin B, 18 other patients with graft-versus-host disease, 5 with splenomegaly and 3 with veno-occlusive disease (VOD), fresh platelets performed better than stored platelets, showing recoveries of 27%/18%, 29%/15%, 15%/1%, 22%/3%. Furthermore, the need for retransfusion within 24 hours was significantly increased with stored platelets. In 19 patients with anti-HLA allo-immunization who were transfused with HLA-matched fresh and stored APC, efficiency was similar (38%/36% and D4/D3). This study indicates that the storage has a major detrimental effect on platelet recovery and survival in patients with certain clinical conditions.

Adolescent↗
PubMed1993

[Reduction of the post-transfusion hepatitis C risk in patients undergoing bone marrow allograft].

Post-transfusion hepatitis C incidence was studied in a series of patients with bone marrow allograft. The risk of HCV seroconversion was evaluated according to the date of grafting and the screening tests carried out in blood donors at this time. Anti-HCV antibodies were screened using Elisa tests of 2d generation and confirmed by Riba tests of 2d generation. Results were analysed. Out of 181 allografted patients from January 1987 to December 1991, 120 patients found anti-HCV negative prior to grafting, with at least six month post-transfusion follow-up were considered as evaluable in terms of HCV seroconversion. All these patients had received leucodepleted blood products and the most of them platelet unit concentrates. Prior to implementation of screening tests for non-A, non-B hepatitis, 14% of patients had seroconverted (0.44% per transfused product); after introduction of the screening for indirect markers (ALAT) and for antibodies directed against the antigen of hepatitis B virus core (anti-HBc), the seroconversion incidence was 4% (0.26% per product). At the present time, since the implementation of anti-HCV screening tests, the risk has reached 1.6% (0.03% per transfused product). 6 patients out of 7 having seroconverted have been developing chronic hepatitis.

Adolescent↗
PubMed1993

Frozen blood and transfusion-transmitted hepatitis C virus.

The purpose of the present study was to evaluate the impact of frozen red cell transfusion on the transmission of hepatitis C virus (HCV) before the introduction of blood donor screening. Anti-HCV antibodies were detected in 59 patients with sickle-cell disease who required chronic transfusions and had exclusively received frozen red blood cells (RBC). The files were reviewed for clinical signs of chronic hepatitis C. Anti-HCV antibodies were detected in 2 adult patients; both also had clinical evidence of HCV infection. No other patient showed signs of acute or chronic HCV hepatitis. In a control group of 28 patients who had received nonfrozen RBC transfusions, the prevalence of anti-HCV antibodies was 25%. So, our study seems to indicate that the use of frozen RBC had reduced the risk of HCV contamination.

Adolescent↗
PubMed1993

[Value of filariopheresis in the treatment of Loa loa filariasis].

To prevent the side effects as encephalitis, related with diethylcarbamazine treatment in loiasis, an exchange blood transfusion was proposed. To avoid the disadvantage of this heavy technique, the authors are proposing filariopheresis to trap the microfilariae using cytapheresis technique and filtration. They obtained a medium 75 p. cent microfilariae extraction: 55-70 p. cent by cytapheresis and 5-20 p. cent by filtration. The number of blood cells must be supervised as an important decrease of the platelets may occur temporary. This simple and not expensive technique is efficient, but diethylcarbamazine treatment must be instituted very quickly after filariopheresis session. Furthermore, the millions of microfilariae collected can provide useful antigen for immuno-parasitological tests.

Adult↗
PubMed1988

[Changes in serum lipids and lipoproteins in 3 cases of heterozygous familial hypercholesterolemia treated by LDL apheresis on dextran sulfate-cellulose columns].

Three patients with heterozygote type IIa hyperlipoproteinemia were treated by specific LDL apheresis with a dextran sulfate-cellulose column every two weeks. Each apheresis resulted in a fall in total cholesterolemia of about 50 p. 100 with a parallel fall in apoprotein B. The average drop of 15 p. 100 in HDL-cholesterol appeared to be due to the hemodilution induced at the end of apheresis. After two months, cholesterol and apoprotein B concentrations before removal were 15 p. 100 lower than baseline values. Treatment was well tolerated. These findings appear encouraging for the treatment of heterozygote forms of familial hyperlipoproteinemia resistant to chemotherapy.

Adult↗
PubMed1988

[Plasma exchange in polyradiculoneuritis in AIDS].

Plasma exchange was used in three cases of peripheral neuropathy of polyradiculoneuritis type in patients with AIDS. The neurologic lesion in the first case was due to a cytomegalovirus, and plasma exchange appeared to provide additional benefits (to antiviral treatment) during the first attack of polyradiculoneuritis. The peripheral neurologic disorders were probably related to the HIV itself in the other two cases, and plasma exchange was carried out only briefly because of the seriousness of the situation, which was unaffected. Although plasma exchange is possible, if particular technical precautions are taken, in patients with AIDS, the present series is too small for valid scientific evaluation.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Apheresis experience with a continuous flow cell separator.

The Dideco Vivacell separator is a continuous-flow centrifugation system that has only recently been used for cytapheresis. The authors' experience with this separator in 451 plateletpheresis and 164 leukapheresis procedures is presented. Platelet collection provided high platelet yields (9.53 +/- 2.85 X 10(11) with a collection efficiency of 74 +/- 14 percent for about 6 liters of total blood processed. Functional integrity was confirmed by normal in vitro tests (aggregation and response to hypotonic stress) and good in vivo recovery (55%). In leukapheresis, white cell yields were high (3.42 +/- 1.2 X 10(10) with 85 percent polymorphonuclear neutrophil cells. Their oxidative metabolism functions (generation of free oxygen radicals), investigated by chemiluminescence, were increased over donor values. Donor reactions, all of the mild citrate type, were rare.

Blood Component Removal↗
PubMedDate not supplied

Peripheral blood stem cell collection with a blood cell separator.

Forty-three patients with malignant nonmyeloid diseases underwent peripheral blood stem cell collections on an apheresis system (Spectra, COBE BCT, Lakewood, CO). Collections took place during the white cell (WBC) recovery phase following conditioning chemotherapy. One hundred two procedures were done after chemotherapy alone, and 72 procedures after chemotherapy plus granulocyte-colony-stimulating factor (G-CSF). Four centrifugal separation factors were tested. One and one-half patient blood volumes were processed in each procedure. The mean volume of the collected component was 158 +/- 16 mL. After chemotherapy alone, the procedures provided a mean of 0.8 x 10(8) WBCs per kg and 2.3 x 10(4) colony-forming units-granulocyte macrophage (CFU-GM) per kg of recipient body weight. The mononuclear cell percentage in the components increased with the centrifugal separation factor from 85 to 96 percent. In parallel, platelet contamination increased from 2.1 to 3.8 x 10(11). The collect hematocrit ranged from 1.0 to 2.5 percent (0.01-0.025). The collection efficiency for mononuclear cells and CFU-GM also increased with the centrifugal separation factors from 52 to 70 percent for mononuclear cells and from 55 to 68 percent for CFU-GM. Collections performed after G-CSF-stimulated mobilization were characterized by a higher neutrophil contamination independent of centrifugal separation factor, which gave a mean mononuclear cell percentage of 64 percent in the collected component. The average yield for these procedures was 2 x 10(8) WBCs per kg and 28 x 10(4) CFU-GM per kg.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗