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Biomedical subjects

G M Spurll

Publications and source records attributed to G M Spurll.

8 recordsLinked to original sources

Neonatal alloimmune thrombocytopenia due to anti-HPA-2b (anti-Koa).

Most severe cases of neonatal alloimmune thrombocytopenia (NAIT) are due to anti-HPA-1a (anti-PlA1) antibodies. We report a case of NAIT due to anti-HPA-2b that resulted in in utero intracranial hemorrhage.A 33-year-old G2P1A0 Caucasian woman had a routine ultrasound at 34 weeks. The fetus appeared to have a left hemispheric hematoma. IVIG, 1g/kg, was started immediately and administered weekly until delivery. One day after receiving the first dose of IVIG, fetal platelet count was 18 x 10(9)/L, and Hb was 116 g/L. Eleven mL of matched platelets compatible by monoclonal antibody immobilization of platelet antigens (MAIPA) assay were transfused in utero, raising the platelet count to 62 x 10(9)/L. Repeat transfusions were done later that week and 1 week later, with pretransfusion counts of 19 x 10(9)/L and 16 x 10(9)/L, respectively. Delivery by C section was done at 35.5 weeks, after the third platelet transfusion. Platelet count at birth was 77 x 10(9)/L. Drainage of the hematoma was performed after transfusion. Testing with a solid phase ELISA revealed reactivity against GP1b/IX. MAIPA testing after platelet treatment with the protease inhibitor leupeptin demonstrated the presence of anti-HPA-2b. On PCR-SSP the mother was HPA-2a homozygous, the father was HPA-2a/2b. Antibodies against the HPA-2b antigen located on the GP1b/IX complex have been reported in rare cases of NAIT. Testing is complicated by proteolytic degradation of the antigen-bearing fragment. Compatible platelets are easily found since approximately 85 percent of donors are HPA-2a/2a.

Journal Article↗

Megakaryocytic colony-stimulating activity in patients receiving a marrow transplant during hematopoietic reconstitution.

Megakaryocytic colony formation is dependent upon growth-stimulating activities present in human serum or plasma. Factors with diverse biological activities including megakaryocytic colony-stimulating activity (Mk-CSA) are provided by the medium of mitogen stimulated peripheral mononuclear cells or subsets of peripheral T cells. In this communication we describe the stimulatory activity of plasma collected from allogeneic and autologous bone marrow transplant recipients on the growth of megakaryocytic colonies. Mk-CSA was found to increase after transplantation as bone marrow regenerated. The stimulatory activities for CFU-M were greater in plasma from allogeneic bone marrow transplant patients receiving T cell-depleted donor marrow than in patients receiving unmodified donor marrow. Growth-promoting activities derived from mitogen-stimulated lymphocytes of T4 phenotype, a potent source of Mk-CSA, did not increase the frequency of CFU-M when cultured in plasma collected from transplant patients receiving a T cell-depleted donor marrow. However, a further increase in the number of CFU-M was observed when exogenous Mk-CSA was added to the cultures supplemented with plasma from patients receiving unmodified donor marrow. Plasma of patients who received autologous marrow displayed similar Mk-CSA activity when compared with the activity of plasma obtained from transplant recipients receiving an unmodified allogeneic donor marrow. Stimulatory activities supporting multilineage colonies (CFU-GEMM), erythroid bursts (BFU-E), and granulocytic colonies (CFU-C) derived from plasma of the three different transplant groups revealed no statistical difference with respect to the frequency of CFU-GEMM, BFU-E, or CFU-C colonies when compared with pretransplant plasma. The results suggest that MK-CSA may play an important role in the regulation of megakaryopoiesis in vivo. Moreover the data suggest the presence of humoral regulators that appear to be different with respect to the processing of the donor marrow.

Antineoplastic Agents↗

T-cell depletion with ricin A-chain T101 in allogeneic bone marrow transplantation to prevent severe graft-versus-host disease.

Bone marrow cells from 10 marrow transplant donors were treated with an immunotoxin, which couples A-chain of ricin with a monoclonal anti-T-cell antibody T101 to prevent graft-versus-host disease by the elimination of mature T-cells. Marrow cells treated with the anti human T-cell immunotoxin (IT101) were cultured for erythropoietic colonies, granulocytic colonies, and multilineage hematopoietic colonies (CFU-GEMMT) containing myeloid cells and T-cells, and optimal conditions were defined for the elimination of T-cells present in the harvested donor marrow prior to marrow transplantation. Marrow samples purged with IT101 were examined for residual T-cells by fluorescence activated cell sorting, using anti-T-cell antibodies, [3H]-thymidine incorporation after PHA stimulation, and an assay for clonogenic T-cells. The number of T-cell colonies observed in the treated marrows was less than 5% of the number in comparable unpurged donor marrows. Treatment with IT101 did not alter the plating efficiency of hematopoietic colonies compared to untreated donor marrow cells. These data suggest that multilineage progenitors responsible for the reconstitution of the recipient hematopoietic system are not affected by marrow IT101 purging. The clinical data on 10 patients indicate that the depletion of T-cells in the donor marrow with IT101 is effective in decreasing the severity of acute graft-versus-host disease in allogeneic marrow transplantation and warrants continued investigation.

Adult↗

Tthyd, a new thymocyte alloantigen linked to Igh-1. Implications for a switch mechanism for T cell antigen receptors.

Tthyd is an alloantigen coded for by a gene(s) near the immunoglobulin locus on chromosome 12 in the mouse. This T cell-specific antigen may be the third member of a family of antigen receptors on T cells encoded by a cluster of genes in the IgT-C region. This antigen is preferentially expressed on thymocytes in contrast to Tindd or Tsud that are expressed on peripheral T cells. The hypothesis that T cell receptors undergo a switch in surface isotype upon maturation is discussed.

Animals↗

Development of a cell line secreting monoclonal antibody specific for concanavalin A and use of that antibody as an affinity immunosorbent for tissue culture media used to support long-term T cell growth.

A new cell line, 71A7, secreting a monoclonal mouse IgG1 antibody specific for the protein concanavalin A (Con A) has been established. The stable and rapidly growing line has been propagated in vitro for several months without loss of secretion of antibody. Affinity purified antibody has been used as an immunoadsorbent to remove Con A from tissue culture supernatants for long-term T cell maintenance.

Animals↗

Simultaneous occurrence of sarcomas in a husband and wife.

The simultaneous occurrence of sarcomas in a husband and wife is documented. The wife first presented with an undifferentiated uterine sarcoma, and within six months of the onset of her disease her husband developed an anaplastic liposarcoma. This finding is considered in the light of recent evidence suggesting a possible viral etiology for human sarcomas.

Aged↗