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Biomedical subjects

L O Cook

Publications and source records attributed to L O Cook.

6 recordsLinked to original sources

High-dose chemotherapy followed by reinfusion of a high number of CD34+ progenitor cells is frequently associated with development of fever in the postengraftment period.

Twenty-nine patients received high-dose chemotherapy and autologous stem cell transplantation from June 1997 to December 1998. The number of CD34+ cells reinfused was 2.4 x 10(6) to 69.0 x 10(6)/kg. Twelve patients developed a fever in the immediate postengraftment period. One patient had a documented infection that could account for the fever; a second patient had a rash and biopsy proven acute graft-versus-host disease (GvHD) that responded to steroids. In the other 10 patients (30%) there was no identifiable cause of the fever. One of these patients received 4.2 x 10(6) CD34+ cells/kg. The other nine received 22.0 x 10(6) to 69.0 x 10(6) CD34+ cells/kg. In our series of 29 patients, 9 of the 11 (82%) patients who received > 20 x 10(6) CD34+ cells/kg developed fever in the postengraftment period. There was a significant association between the number of CD34+ cells (<20 vs. >20 x 10(6)) and occurrence of fever (odds ratio = 76.5; p = 0.00005). Even though they engrafted promptly (7 to 9 days), the fever required evaluation for infection, blood cultures, antibiotic treatment, and observation. This required additional hospitalization of 1 to 7 days. These data suggest that a high number of CD34+ cells is frequently associated with post-engraftment fever and prolongation of the hospital stay. Should there be an upper limit in the number of reinfused CD34+ cells is a question that has to be addressed and possibly studied.

Adult↗

Antibodies to low-incidence antigens and elimination of the antihuman globulin phase of the crossmatch-case report: anti-Wra.

An antibody to a low-incidence antigen was identified in the serum of a nontransfused male patient. The antibody was subsequently identified as anti-Wra and was only detectable at the antihuman globulin (AHG) phase of the crossmatch. Instances of severe hemolytic transfusion reactions have been reported following the transfusion of red blood cells containing low-incidence antigens in patients with antibodies directed toward these antigens (e.g., anti- Wra, -Cob, -Jsa, etc.). Elimination of the AHG phase of the crossmatch can result in either risks or benefits. Since patients seen at this facility primarily have been multitransfused or are multiparous females, the AHG phase of the crossmatch has been maintained.

Journal Article↗

Case report: a pregnant woman with immune thrombocytopenic purpura and unusual red cell antibodies.

Maternal immune thrombocytopenic purpura (ITP) may lead to fetal platelet destruction. This process is mediated by IgG platelet autoantibodies that cross the placenta. In this case, not only were platelet autoantibodies present, but red cell alloantibodies anti-E, anti-M, and anti-He were also present. Anti-E, present as an IgG antibody, crossed the placenta, but did not cause clinical problems in the E+ newborn, other than possible hyperbilirubinemia that was treated by phototherapy.

Journal Article↗

In vitro tests for platelet compatibility.

Four methods were investigated to determine their suitability as platelet compatibility procedures: leukoagglutination, lymphocytotoxicity, platelet suspension immunofluorescence and platelet enzyme-linked immunosorbant assay. None of the tests were found to reliably predict the 24-hour-posttransfusion platelet increment in 8 refractory thrombocytopenic patients judged refractory to random donor platelet therapy.

Blood Grouping and Crossmatching↗

In vitro functional capabilities of canine polymorphonuclear neutrophils collected simultaneously by continuous-flow centrifugation and continuous-flow filtration leukopheresis.

Polymorphonuclear neutrophils were simultaneously collected from dogs by continuous-flow centrifugation and continuous-flow filtration leukapheresis. In vitro studies were performed on cells obtained by the two methods as well as on control cells. Studies consisted of assessment of phagocytic capacity, degranulation, chemotaxis, hexose monophosphate (HMP) shunt activity, and bacterial killing. The cells obtained from the filter were metabolically more active than those harvested by centrifugation, as evidenced by increase in resting HMP shunt activity and dimunition in total available lysozyme-secreting activity compared to centrifuged cells. Despite their impaired phagocytic capacities, the filtered cells were able to kill Staphylococcus aureus as efficiently as the centrifuged cells. Both cell populations responded to chemotactic gradients equally.

Animals↗