Full Description
As a clinical discipline blood transfusion encompasses enormous vista, vary ing from biotechnology to molecular biology, from plasma products, cell biology and growth factors to interleukines. Growth of knowledge in this field has been rapid, and expertise is now required to be mastered and renewed in translating these ideas for patient care. Various types of cells could be harvested - progenitor stem cells derived from bone marrow or from circulating blood as a source for transplants; in the hemostatic armoury platelets could be used prophylactically; granulocytes and mononuclear cells are available for treatment of infections or immune modulations. However, their therapeutic use carries potential complications including graft versus host disease and CMV-infection. Prevention of such complications by irradiation and by removal of immunocompetent leukocytes are important issues. Thus, production of such therapeutic materials ought to address the issues at the earliest, to eliminate those problems while adhering to the con cept of high quality; the impact of storing platelets for longer periods by using improved plastic containers or storing almost indefinitely in frozen state should be explored. Rapid progress in cell culture techniques and bio technology have enriched the transfusion medicine armoury with lympho kines, interferons and cell colony growth factors which have great potentials for enhancement of basic knowledge as well as considerable therapeutic applications in patients.
Contents
I. Principles and functional aspects.- The human MHC (HLA) and immediate relevance in transfusion Practice.- Alloimmunization against platelets and granulocytes.- Leukocytes in transfusion medicine — an overview of functions and clinical implications.- Platelet functions and platelet transfusion.- Discussion.- II. Clinical Aspects.- A.Presence of cells.- Platelet transfusion.- Prospective selection of compatible platelet donors for alloimmunized patients by an ELISA platelet cross-match only.- White blood cell transfusions in the immuno-compromised patients.- Immunization with antigen-bound antibody: an experimental approach to prevention of sensitization to allogeneic blood cells.- Autologous bone marrow transplantation in acute myeloblastic leukemia (AML): in vitro studies to detect minimal disease in remission marrow.- Autologous bone marrow transplantation in solid malignancies.- Discussion.- Clinical use of leukocyte poor red cell concentrates.- Management and prevention of cytomegalovirus infection.- Graft-versus-Host disease and the role of blood product irradiation.- Perspectives for lymphokine therapy: from genetic engineering to immunologic engineering.- Discussion.- III. Production aspects.- Practical aspects of platelet concentrate production and storage.- Surge plateletapheresis.- Platelets and propylene glycol: an approach to freezing platelets in the presence of a new cryoprotectant.- Bacterial contamination in platelets stored at ambient temperature.- Preparation of leukocyte-poor blood.- Use of hemapheresis-derived hemopoietic stem cells for transplantation in malignant lymphohemopoietic disorders.- Purging of bone marrow.- Discussion.- IV. Laboratory aspects.- HLA-matching and crossmatching in platelet transfusion.- Cell culture and immune functiontests.- Platelet antibody detection.- Decreased fluidity of human platelet membranes after interaction with an anti PLA1 antibody.- Role of white cells in reagents for AIDS.- Discussion.
