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Dijkstra-Tiekstra M.J.,Sanquin Blood Supply | van de Watering L.M.G.,Sanquin Jon J van Rood Center for Clinical Transfusion Research | Rondeel J.M.M.,Isala Klinieken | Slomp J.,Spectrum | de Wildt-Eggen J.,Sanquin Blood Supply
Transfusion Medicine | Year: 2014

SUMMARY: Objectives: To study the effect of extended storage of platelet concentrates (PCs) and the implementation of a new platelet pooling system for PCs on corrected count increment (CCI) after transfusion. Background: Due to new developments and changes in processes or procedures, one should remain alert for the effects of these changes. Besides in vitro studies and validation, in vivo studies are also important, as it has been shown that in vitro results do not always predict in vivo outcomes. Methods/Materials: After introduction of extended storage of PCs for 5-7days prepared from five buffy coats and plasma, transfusion monitoring for transfusions of PCs in haemato-oncological patients was set up. After 9months, a new pooling system for PCs was implemented, Composelect instead of Optipure PLT, and transfusion monitoring was continued for another 8months. The CCI was used as primary outcome. Results: In total, 93 patients were included and transfused with PCs prepared in the Optipure PLT system (262 transfusions) or in the Composelect system (127 transfusions). Extended storage of PCs for 7days had no significant effect on CCI. Although the implementation of the Composelect system did not influence the CCI1h (13·8±6·0 vs 13·0±5·8; n.s.), it seemed to have a positive effect on CCI24h (7·0±4·9 vs 4·7±4·5; P<0·05). Conclusion: Although the influence of confounders could not be excluded, it seemed that implementation of the Composelect system for PCs led to an improved CCI24h and that extended storage of PCs did not influence the CCI. © 2014 British Blood Transfusion Society.

Ciceri F.,San Raffaele Scientific Institute | Lupo-Stanghellini M.T.,San Raffaele Scientific Institute | Korthof E.T.,Leiden University | Korthof E.T.,Sanquin Jon J van Rood Center for Clinical Transfusion Research
Bone Marrow Transplantation | Year: 2013

Haploidentical SCT (haplo-SCT) has been considered a therapeutic option in patients with acquired severe aplastic anemia (SAA) failing at least one course of immune suppressive therapy with antithymocyte globulin and lacking an HLA-matched related or unrelated donor. The platforms of both ex vivo T-cell-depleted and unmanipulated grafts have been explored in children and adults. Overall, the primary objective of a stable haploidentical hematopoietic engraftment with a low rate of GVHD is unmet in a significant proportion of patients undergoing haplo-SCT for SAA. Haploidentical transplants for refractory SAA should be performed in a specialist center with major experience in hematopoietic SCT procedures and preferably performed within the framework of a local clinical protocol designed specifically to address the prevention of graft rejection and GVHD. © 2013 Macmillan Publishers Limited All rights reserved.

Ayas M.,King Faisal Specialist Hospital And Research Center | Nassar A.,King Faisal Specialist Hospital And Research Center | Hamidieh A.A.,Tehran University of Medical Sciences | Kharfan-Dabaja M.,American University of Beirut | And 13 more authors.
Bone Marrow Transplantation | Year: 2013

BM failure (BMF) is a major and frequent complication of dyskeratosis congenita (DKC). Allogeneic hematopoietic SCT (allo-HSCT) represents the only curative treatment for BMF associated with this condition. Transplant-related morbidity/mortality is common especially after myeloablative conditioning regimens. Herein, we report nine cases of patients with DKC who received an allo-SCT at five different member centers within the Eastern Mediterranean Blood and Marrow Transplantation Registry. Between October 1992 and February 2011, nine DKC patients (male, 7 and female, 2), with a median age at transplantation of 19.1 (4.9-31.1) years, underwent an allo-HSCT from HLA-matched, morphologically normal-related donors (100%). Preparative regimens varied according to different centers, but was reduced intensity conditioning (RIC) in eight patients. Graft source was unstimulated BM in five cases (56%) and G-CSF-mobilized PBSCs in four (44%) cases. The median stem cell dose was 6.79 (2.06-12.4) × 106 cells/kg body weight. GVHD prophylaxis consisted of CsA in all nine cases; MTX or mycophenolate mofetil were added in five (56%) and two (22%) cases, respectively. Anti-thymocyte globulin was administered at various doses and scheduled in four (44%) cases. Median time-to-neutrophil engraftment was 21 (17-27) days. In one case, late graft failure was noted at 10.4 months post allo-HSCT. Only one patient developed grade II acute GVHD (11%). Extensive chronic GVHD was reported in one case, whereas limited chronic GVHD occurred in another four cases. At a median follow-up of 61 (0.8-212) months, seven (78%) patients were still alive and transfusion independent. One patient died of metastatic gastric adenocarcinoma and graft failure was the cause of death in another patient. This study suggests that RIC preparative regimens are successful in inducing hematopoietic cell engraftment in patients with BMF from DKC. Owing to the limited sample size, the use of registry data and heterogeneity of preparative as well as GVHD prophylaxis regimens reported in this series, we are unable to recommend a particular regimen to be considered as the standard for patients with this disease. © 2013 Macmillan Publishers Limited.

Wiersum-Osselton J.C.,TRIP Transfusion Reactions in Patients Dutch National Hemovigilance Office | Politis C.,Hellenic Coordinating Haemovigilance Center | Brand A.,Sanquin Jon J van Rood Center for Clinical Transfusion Research | van der Bom J.G.,Sanquin Jon J van Rood Center for Clinical Transfusion Research | And 2 more authors.
Vox Sanguinis | Year: 2013

European Union member states must have national haemovigilance reporting of serious adverse reactions and events. We sent national competent authorities an email questionnaire about data validation. Responses were received from 23/27 countries. Nine previously had no national haemovigilance system. In 13 (57%), the serious adverse reactions and events can be verified. Coverage of blood establishments is documented in 20 systems (87%) and of hospitals in 15 systems (65%). Although all member states have implemented haemovigilance systems, there are currently wide variations in data quality assurance, not allowing comparisons between countries. © 2012 International Society of Blood Transfusion.

PubMed | Sanquin Jon J van Rood Center for Clinical Transfusion Research
Type: Journal Article | Journal: BMJ open | Year: 2012

Individuals exposed to red blood cell alloantigens through transfusion, pregnancy or transplantation may produce antibodies against the alloantigens. Alloantibodies can pose serious clinical problems such as delayed haemolytic reactions and logistic problems, for example, to obtain timely and properly matched transfusion blood for patients in which new alloantibodies are detected.The authors hypothesise that the particular clinical conditions (eg, used medication, concomitant infection, cellular immunity) during which transfusions are given may contribute to the risk of immunisation. The aim of this research was to examine the association between clinical, environmental and genetic characteristics of the recipient of erythrocyte transfusions and the risk against erythrocyte alloimmunisation during that transfusion episode. METHODS AND ANALYSIS STUDY DESIGN: Incident case-cohort study.Secondary care, nationwide study (within the Netherlands) including seven hospitals, from January 2005 to December 2011.Consecutive red cell transfused patients at the study centres.The study cohort comprises of consecutive red blood cell transfused patients at the study centre. EXCLUSION: Patients with transfusions before the study period and/or pre-existing alloantibodies.Cases defined as first time alloantibody formers; Controls defined as transfused individuals matched (on number of transfusions) to cases and have not formed an alloantibody.Logistic regression models will be used to assess the association between the risk to develop antibodies and potential risk factors, adjusted for other risk factors.Approval at each local ethics regulatory committee will be obtained. Data will be coded for privacy reasons. Patients will be sent a letter and an information brochure explaining the purpose of the study. A consent form in presence of the study coordinator will be signed before the blood taking commences. Investigators will submit progress summary of the study to study sponsor regularly. Investigators will notify the accredited ethics board of the end of the study within a period of 8 weeks.

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