Transfusion and Apheresis Science RSS feed: Current Issue. The 2010 13th International Conference WAA-ESFA Congress, Switzerland, 1-4 September 2010. For more information click here Transfusion and Apheresis Science (previously called Transfusion Science ) brings comprehensive and up-to-date information to physicians and health care professionals involved in the rapidly changing fields of transfusion medicine and apheresis. The journal presents original articles relating to scientific and clinical studies in the areas of immunohematology, transfusion practice and both therapeutic and donor apheresis. Topics covered include the collection and processing of blood, compatibility testing and guidelines for the use of blood products, as well as screening for and transmission of blood-borne diseases. All areas of apheresis - both therapeutic and collection - are also addressed. A major feature of the journal is the " theme " section which includes, in each issue, a group of papers designed to review a specific topic of current importance in transfusion science; basic science, current research and the clinical application of modern therapies are featured. The " Apheresis Listening Post " provides a forum for the discussion of topical issues specific to apheresis and focuses on the operators' viewpoint. Another feature section is "What's Happening" which provides informal reporting of activities in the field. In addition, brief case reports and Letters to the Editor , as well as reviews of meetings and events of general interest, and a listing of recent patents make the journal a complete source of information for practitioners of transfusion and apheresis science. Immediate dissemination of important information is ensured by the commitment of Transfusion and Apheresis Science to rapid publication of both symposia and submitted papers. http://www.trasci.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Transfusion and Apheresis Science1473-0502423June 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.trasci.com/article/PIIS147305021000073X/abstract?rss=yesEditorial board/Publication information10.1016/S1473-0502(10)00073-XTransfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0IFCIFChttp://www.trasci.com/article/PIIS1473050210000698/abstract?rss=yesAs we head into the summer of 2010 we are delighted to bring you a theme section dealing with virtually every aspect of cord blood cell transplantation. This wonderful series of papers was put together by Dr. Pablo Rebulla from Italy. Dr. Rebulla has organized this section to cover the many aspects of this evolving field ranging from a world wide update from Dr. Garcia to a European survey on clinical use, information on the Milano cord blood bank, the activities in France, a description of the process of decision making regarding donations, and the quality assurance of this important product. The specific issue of cord cell transplantation for hemoglobinopathies is addressed by Bonicimino and coworkers. The final paper by Sciomer reminds us that the Italians have an early lead with a 15years history of such activities. In much of the rest of the world this is still an area of early evolution and I know we will all learn much from reading this series of papers.Editorial – Issue 42.3Gail Rock10.1016/j.transci.2010.03.013Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Editorial221221http://www.trasci.com/article/PIIS1473050210000649/abstract?rss=yesAbstract: There have been several retrospective studies reporting severe adverse events of mortality and morbidity associated with blood transfusions. Mortality and morbidity associated with posttransfusion infection, transfusion related acute lung injury (TRALI), and systemic inflammatory response syndrome (SIRS) have been reported in patients undergoing cardiac surgery, after massive transfusions for severe traumatic injuries, and after transfusions for elective and emergency indications. After 35days of storage at 4°C in additive solutions, RBC have 24-h posttransfusion survival values of 75% but do not function satisfactorily. For RBC to function satisfactorily shortly after transfusion, they should be stored at 4°C for no more than 2weeks. Yet while the FDA requires a 24-h posttransfusion survival value of 75%, there is no requirement for the function of the transfused RBC. It has been shown that red blood cells that circulate and function immediately or shortly after transfusion exert a very important hemostatic effect to reduce the bleeding time and nonsurgical blood loss in anemic and thrombocytopenic patients. Greater restoration of hemostasis is seen with viable and functional RBC transfusions than with platelets or plasma even though the platelets and plasma proteins may have satisfactory viability and function.The length of storage of the blood products affects their survival and function and the transfusion of nonviable compatible RBC, antibodies to granulocytes and WBC HLA antigens and biologically active substances affects the patient’s clinical outcome. One of the easiest ways to prevent the severe adverse events that have been observed is to ensure that the transfused blood products survive and function at an optimum level and that the levels of antibodies to granulocytes and WBC HLA antigens and biologically active substances are eliminated or reduced. The best way to ensure this is to store liquid-preserved leukoreduced human red blood cells at 4°C in additive solutions for no more than 2weeks and leukoreduced platelets at room temperature for no more than 2days. These liquid-preserved blood products can be used in conjunction with frozen RBC, platelets, and plasma stored in −80°C mechanical freezers and will avoid the need for fresh whole blood and prevent the severe adverse events associated with the transfusion of blood products.An approach to prevent the severe adverse events associated with transfusion of FDA-approved blood productsC. Robert Valeri, Gina Ragno10.1016/j.transci.2009.08.001Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Submitted Papers223233http://www.trasci.com/article/PIIS1473050210000650/abstract?rss=yesAbstract: A case of severe AIHA caused by pan-agglutinant IgG-class antibodies was resolved with therapeutic plasma exchange, transfusions and steroids to maintain acceptable hemoglobin levels, remove free hemoglobin, reduce the title of autoantibodies and sustain cardiopulmonary functions.A life-threatening case of autoimmune hemolytic anemia successfully treated by plasma-exchangeCésar Cerdas-Quesada10.1016/j.transci.2010.03.012Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Submitted Papers235237http://www.trasci.com/article/PIIS1473050210000637/abstract?rss=yesAbstract: Leukemia relapse is a serious therapeutic challenge following hematopoietic stem cell transplantation (HSCT). In this retrospective study, 23 patients [15 (65.2%) AML, 8 (34.8%) ALL] who received DLI±reinduction chemotherapy for post-transplant relapse were reviewed. The overall response rate of DLI was 66.7% for AML and 50% for ALL. A total of 15 patients (65.2%) developed acute graft versus host disease (GVHD). Response rates were higher in patients with GVHD (80% versus 25%; p=0.01; OR: 12.0). The probability of OS was better in patients who respond to DLI (p=0.04). Further strategies are required to improve the anti-tumor properties of alloreactive donor lymphocytes and to obtain durable responses with DLI in patients with relapsed acute leukemia after allogeneic HSCT.Donor lymphocyte infusion for leukemia relapse after hematopoietic stem cell transplantationZeynep Arzu Yegin, Zübeyde Nur Özkurt, Şahika Zeynep Aki, Gülsan Türköz Sucak10.1016/j.transci.2010.03.011Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Submitted Papers239245http://www.trasci.com/article/PIIS1473050210000534/abstract?rss=yesAbstract: Background: Cryoglobulinemia is an immune-complex-mediated systemic vasculitis involving small-to-medium-sized vessels. Plasmapheresis transiently removes the circulating cryoglobulins and has been advocated (in conjunction with immunosuppressive therapy) to be effective in reducing morbidities associated with cryoglobulinemia. The goal of this paper was to review over the past 20years the medical literature for evidence supporting or refuting the reported use of plasmapheresis for cryoglobulinemia (January 1988 through June 2008).Methods: We included all reported literature of the use of plasma exchange for the treatment of cryoglobulinemia that included at least five patients. Electronic searches were performed using MEDLINE (January 1988 through June 2008) and Cochrane Central Register of Controlled Trials (January 1988 through June 2008).Results: Of the 11 articles included in this review, there were a total of 156 patients studied. Two studies used cryofiltration, one compared plasma exchange to double cascade filtration and the other eight dealt with plasma exchange only. Outcome measures were often not clearly defined.Conclusions: Although plasma exchange is an accepted treatment for cryoglobulinemia, there are no large multicentre randomized controlled trials of plasma exchange versus placebo or versus immunosuppressive therapy. Of the 11 studies from our literature search, none had a clear report of the apheresis procedures and clearly defined quantitative outcomes. The quality and variability of the evidence precludes a meta-analysis or even a systematic analysis. However, these studies weakly support the use of plasma exchange largely on a mechanistic basis.Plasma exchange for treating cryoglobulinemia: A descriptive analysisM.A. Rockx, W.F. Clark10.1016/j.transci.2010.03.001Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Submitted Papers247251http://www.trasci.com/article/PIIS1473050210000613/abstract?rss=yesAfter two decades of laboratory and clinical experimentation resulting in more than 20,000 transplants in children and adults, the term ‘epilogue’ (derived from the Greek terms epi meaning ‘to the end’ and logos meaning ‘discourse’) used by Broxmeyer in the title of his excellent review on umbilical cord blood transplantation unequivocally highlights the consolidated role of cord blood as a valuable therapeutic source of hematopoietic stem and progenitor cells for family-related and unrelated allogeneic transplantation. The state of the art of the ‘third chronological avenue’ – the first and second being the use of bone marrow and mobilized peripheral blood, respectively – in hematopoietic stem cell transplantation pioneered in 1988 by Gluckman is thoroughly described in nine articles anticipating Broxmeyer’s ‘epilogue’ in a recent themed issue of Seminars in Hematology. Clinicians willing to update their knowledge on the clinical results of cord blood transplantation in several disease groups will find careful descriptions of the pros and cons of cord blood, successes and difficulties in different pathological conditions and guidance on selection of the best cord blood unit for their transplant candidates in Refs. . This evidence on clinical outcomes is complemented by two other recent monographic issues on cord blood published by Bone Marrow Transplantation and by the British Journal of Haematology , which include articles contributed by the main actors currently active in this field.Cord blood banking and transplantation in 2010Paolo Rebulla10.1016/j.transci.2010.03.009Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010253254http://www.trasci.com/article/PIIS1473050210000716/abstract?rss=yesPaolo Rebulla, MD, is a specialist in Clinical and Laboratory Hematology and in Immunohematology. He is the current director of the Center of Transfusion Medicine, Cellular Therapy and Cryobiology and the co-director of the Department of Regenerative Medicine at the Foundation Ca’ Granda Ospedale Maggiore Policlinico in Milano.BiographyPaolo Rebulla10.1016/j.transci.2010.05.001Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010255255http://www.trasci.com/article/PIIS1473050210000625/abstract?rss=yesAbstract: Today Cord Blood (CB) Transplants are accepted as a therapeutic resource for the treatment of a variety of disorders, comparing in some cases, with transplants performed with other sources of progenitors. Unrelated Cord Blood Banks (CBBs) have significantly contributed to this improvement by the improvement on the knowledge of the CB biology and technical developments. Today, there are more than 100 active Cord Blood Banks (CBB), with an inventory of more than 400,000 units, which have generated more than 10000 cord blood transplants all around the world.Access to the world-wide CB inventory, as well as the hemopoietic progenitors inventory from adult donors, is a rather complex task which is continuously subject to improvements and consolidations.The growing numbers of CBBs and the search for efficiency has driven them to constitute or adapt consolidated data bases and access systems, and to develop a number of registries or networks to improvedthe access to inventories.The purpose of the present article is to provide a general overview on the number of CB units stored around the word, the quality accreditation systems and how the CB networks and their national and international inventories and registries are organized in order to support the, every time more efficient search for suitable CB units for patients lacking family donors.Allogeneic unrelated cord blood banking worldwide: An updateJ. Garcia10.1016/j.transci.2010.03.010Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010257263http://www.trasci.com/article/PIIS1473050210000601/abstract?rss=yesAbstract: This report describes the evolution of Cord Blood (CB) hematopoietic stem cell transplants (HSCTs) in Europe over time and its current status. There were 687 patients with a first CB HSCT and a total of 763 allogeneic CB HSCT but no autologous CB HSCT reported in the year 2008. The 687 first transplants correspond to 6% of the total 11,408 allogeneic HSCT. All CB HSCT were for haematological indications; there were no CB transplants reported amongst the 598 cellular transplants listed for non-hematopoietic use. Indications were different depending on donor type. Main indications for the 48 HLA identical family donors CB HSCT were non-malignant disorders (36; 75%) and acute leukaemia (8; 17%). Main indications for the 639 unrelated first CB HSCT were acute leukaemia (337;53%), non-malignant disorders (115;18%) and lymphoproliferative disorders (53; 8%). 159 teams out of the 368 teams performing allogeneic HSCT (43%) reported 1 to 37 CB HSCT (median 3). There were significant differences in use of CB in the participating European countries with a median CB transplant number of 6.5 (range 1–207), transplant rate (number of CB HSCT/10 million inhabitants) of 6.3 (range 0.1–234.6) and a proportion of CB amongst allogeneic HSCT from 0.7% to 18.2% (median 5.4%). These data document the established role of CB HSCT in Europe but point to significant differences in its use.European survey on clinical use of cord blood for hematopoietic and non-hematopoietic indicationsAlois Gratwohl, Helen Baldomero10.1016/j.transci.2010.03.008Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010265275http://www.trasci.com/article/PIIS1473050210000583/abstract?rss=yesAbstract: Despite the optimization of conventional treatment, both thalassemia and sickle cell disease are still associated with significant morbidity and mortality, especially in developing countries. Allogeneic transplantation of hematopoietic progenitors is the only curative treatment and represents an attractive option for these patients. In view of the low incidence of graft-versus-host disease associated with the procedure, allogeneic cord blood transplantation (CBT) is particularly appealing for patients with non-malignant disorders. Available evidence indicates that related donor CBT is a safe and effective option for patients with hemoglobinopathies, able to offer results at least as good as those reported using bone marrow cells.Cord blood transplantation in patients with hemoglobinopathiesAgata Boncimino, Alice Bertaina, Franco Locatelli10.1016/j.transci.2010.03.006Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010277281http://www.trasci.com/article/PIIS1473050210000595/abstract?rss=yesAbstract: In this article we examined the role of HLA incompatibility, of KIR C1 and C2 ligands and of other clinical factors on 99 cord blood transplants performed using single units from Milano Cord Blood Bank (MICB). We analyzed the occurrence of rejection, overall patient survival (OS) and occurrence of acute GvHD ⩾2 grade (severe aGvHD). No correlation was found between the end points and the number of HLA-A,-B, -DRB1 and -DQB1 mismatches. Only HLA-C disparities are associated with the occurrence of rejection (P=0.03). Our results showed that the presence of the C1 ligand in the donor decreased the occurrence of aGvHD (grade ⩾2) in the recipient while recipients of donors expressing the C2 KIR ligand experienced more frequently aGvHD (P=0.03). The HLA-C1 ligand, therefore, proved to have a protective effect towards severe aGvHD. The probability of rejection increased in KIR epitope-mismatched recipient/donor pairs (P=0.01). Finally the stage of disease at transplantation and cell dose were important for patient survival (P=0.003, P=0.048 respectively).The impact of immunogenetics and clinical factors on the outcome of unrelated cord blood transplantation: The Milano Cord Blood Bank dataMarta Serafini, Francesca Poli, Rosanna Torelli, Katharina Fleischhauer, Elisabetta Zino, Alejandro Espadas de Arias, Elena Longhi, Sara Frison, Katherina Karpasitou, Ilaria Pezzali, Lucilla Lecchi, Mario Scalamogna10.1016/j.transci.2010.03.007Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010283288http://www.trasci.com/article/PIIS147305021000056X/abstract?rss=yesAbstract: Cord blood units (CBUs) are increasingly being used for unrelated allogeneic stem cell transplantation and their selection is mainly done according to pre-freezing cell dose and HLA donor/recipient compatibility. The main practical advantage of cord blood transplant (CBT) is represented by an easy and quick CBU procurement, due to the possibility of long-term storage of fully HLA typed CBUs assessed for cell dose and infectious contamination. The main disadvantage consists in a limited cell dose, with the consequent risk of graft failure or engraftment delay. In order to warrant the safety and the efficiency of CBUs selected for clinical use, transplant physicians may check CBU characteristics by requiring quality assessments (QAs) to the cord blood bank (CBB), to be performed on segments attached to and cryopreserved with the bags. However, there is a wide variability concerning CBU-QA with regard to the pre-transplant “release tests”, mainly due to limited availability of segments attached to the CBU and of maternal samples and to difficult communication between Transplant Centres (TCs) and CBBs.The aim of this article is to describe a TC perspective during CBU selection for unrelated transplant, in order to identify an appropriate QA scheme and define the timing when the results need to be acquired. By analyzing the available data, this article describes a model of TC-QA policy able to guide the clinician from CBU selection through the infusion, with the ultimate aim of improving the transplant clinical outcome.Quality assessment of cord blood units selected for unrelated transplantation: A Transplant Center perspectiveAlessandra Picardi, William Arcese10.1016/j.transci.2010.03.004Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010289297http://www.trasci.com/article/PIIS1473050210000571/abstract?rss=yesAbstract: We analysed knowledge, comprehension, opinions, attitudes and choices related to cord blood donation in seven heterogeneous focus groups including pregnant women, future parents, cord blood donors, midwives and obstetricians/gynaecologists. Comparative evaluations focused on attitudes before versus after delivery and preferences of public versus private banking. The study outlined large support to altruistic cord blood donation and need for better health professionals education in this field. Collected information was presented in a public conference and used to develop an informative brochure which was tested for readability and clearliness in four workshops and finally distributed to 26 regional delivery suites.An analysis of decision making in cord blood donation through a participatory approachElena Salvaterra, Sara Casati, Simonetta Bottardi, Antonella Brizzolara, Daniela Calistri, Rosanna Cofano, Emanuela Folliero, Faustina Lalatta, Cristina Maffioletti, Mariangela Negri, Paolo Rebulla10.1016/j.transci.2010.03.005Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010299305http://www.trasci.com/article/PIIS1473050210000546/abstract?rss=yesAbstract: Paradoxically, France is one of the leading exporters of cord blood units worldwide, but ranks only 17th in terms of cord blood units per inhabitant, and imports 64% of cord blood grafts to meet national transplantation demands. With three operational banks in 2008, the French allogeneic cord blood network is now entering an important phase of development with the creation of seven new banks collecting from local clusters of maternities. Although the French network of public banks is demonstrating a strong commitment to reorganise and scale up its activities, the revision of France’s bioethics law in 2010 has sparked a debate concerning the legalisation of commercial autologous banking. The paper discusses key elements for a comprehensive national plan that would strengthen the allogeneic banking network through which France could meet its national medical needs and guarantee equal access to healthcare.Cord blood banking in France: Reorganising the national networkGregory Katz, Antonia Mills10.1016/j.transci.2010.03.002Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010307316http://www.trasci.com/article/PIIS1473050210000558/abstract?rss=yesThe acronym ADISCO stands for Associazione Donatrici Italiane Sangue di Cordone Ombelicale (Italian Association of Cord Blood Donors). ADISCO was founded in 1995 by the initiative of a small group of prominent Italian hematologists and pediatricians including Professors Franco Mandelli, Pier Luigi Rossi Ferrini, Enrico Madon, Girolamo Sirchia (a former ministry of health). These clinicians in turn solicited a group of women who were already active in volunteer organizations promoting and supporting blood donation in different regions of the country, and encouraged them to create a non-profit association specifically devoted to promote amongst women the culture of cord blood donation for allogeneic use.The Italian Association of Cord Blood Donors (ADISCO): 15years of history and activitiesCarolina Sciomer10.1016/j.transci.2010.03.003Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Theme section: Cord blood banking and transplantation in 2010317319http://www.trasci.com/article/PIIS1473050210000704/abstract?rss=yesUpcoming Events10.1016/j.transci.2010.03.014Transfusion and Apheresis Science 42, 3 (2010)2010-06-01Transfusion and Apheresis Science2010-06-01423S1473-0502(10)X0004-0Upcoming Events321322