| The relationship between alloimmunization and posttransfusion granulocyte survival: experience in a chronic granulomatous disease cohort. | |
| | |
MedLine Citation:
|
PMID: 21175646 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
BACKGROUND: The efficacy of granulocyte transfusions in patients with HLA alloimmunization is uncertain. A flow cytometric assay using dihydrorhodamine 123 (DHR), a marker for cellular NADPH oxidase activity, was used to monitor the differential survival of transfused oxidase-positive granulocytes in alloimmunized patients with chronic granulomatous disease (CGD). STUDY DESIGN AND METHODS: Ten patients with CGD and serious infections were treated with daily granulocyte transfusions derived from steroid and granulocyte-colony-stimulating factor-stimulated donors. The proportion of neutrophils with intact oxidase activity was quantitated by DHR fluorescence on samples drawn before and 1 hour after transfusion. The incidence of acute transfusion reactions was correlated with the results of DHR fluorescence and biweekly HLA serologic screening assays. RESULTS: Eight of 10 patients experienced acute adverse reactions in association with granulocyte transfusions. Four had only chills and/or fever, and four experienced respiratory compromise; all eight exhibited HLA alloimmunization. Mean (±SD) oxidase-positive cell recovery was 19.7 ± 17.4% (n = 15 transfusions) versus 0.95 ± 1.59% (n = 16) in the absence and presence of HLA allosensitization, respectively (p < 0.01). Greater than 1% in vivo recovery of DHR-enhancing donor granulocytes was strongly correlated with lack of HLA alloimmunization. CONCLUSION: The ability to detect DHR-positive donor granulocytes by flow cytometry is strongly correlated with absence of HLA alloimmunization and lack of acute reactions to granulocyte transfusions in patients with CGD. If HLA antibodies are present and the survival of donor granulocytes is low by DHR analysis, transfusions should be discontinued, avoiding a therapy associated with high risk and unclear benefit. |
| | |
Authors:
|
K F Heim; T A Fleisher; D F Stroncek; S M Holland; J I Gallin; H L Malech; S F Leitman |
Related Documents
:
|
6391146 - Increase of s-100 immunoreactivity in the urinary bladder from patients with multiple s... 7185886 - Number connection test and continuous reaction times in non-encephalopathic patients: a... 6441956 - Heart rate variation in patients treated with antidepressants. an index of anticholiner... 18424476 - Clinical features of patients with multiple sclerosis from a survey in shanghai, china. 8505276 - Diagnosis and treatment of atraumatic vascular insufficiency of the upper extremity: fe... 6605496 - Ocular counterrolling as an indicator of vestibular otolith function. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2010-12-22 |
Journal Detail:
|
Title: Transfusion Volume: - ISSN: 1537-2995 ISO Abbreviation: - Publication Date: 2010 Dec |
Date Detail:
|
Created Date: 2010-12-23 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0417360 Medline TA: Transfusion Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
© 2010 American Association of Blood Banks. |
Affiliation:
|
From the Departments of Transfusion Medicine and Laboratory Medicine, Warren Grant Magnuson Clinical Center and the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Lack of effect of unrefrigerated young whole blood transfusion on patient outcomes after massive tra...
Next Document: Real-time polymerase chain reaction detection of parvovirus B19 DNA in blood donations using a comme...