An apparent primary immune response involving anti-Jka and anti-P1 detected 10 days after transfusion.
Explore the source record for details and available documents.
Antibody Formation↗
Biomedical subjects
N Blumberg
Publications and source records attributed to N Blumberg.
The second century of ABO: and now for something completely different.
Explore the source record for details and available documents.
ABO Blood-Group System↗
Variability in response to cryoprecipitate treatment for hemostatic defects in uremia.
Cryoprecipitate is frequently administered as treatment for hemostatic defects in patients with uremia. The only published data supporting this approach however, involves seven patients described by Janson and colleagues in whom bleeding times were shortened and bleeding complications reduced after cryoprecipitate infusion. We retrospectively reviewed our institution's experience with cryoprecipitate in this setting. Five patients had sufficiently complete data for evaluation of the efficacy of therapy with cryoprecipitate, including pretreatment bleeding time greater than 15 minutes, normal coagulation studies, and platelet count greater than 100,000/microliters. Two patients had normalization of their bleeding time and a favorable clinical outcome after cryoprecipitate infusion. Three patients failed to shorten their bleeding time after cryoprecipitate infusion or, in one case, multiple infusions. One of these latter patients had correction of his abnormal bleeding time after subsequent administration of deamino-8-D-arginine vasopressin (DDAVP). We conclude that the hemostatic response to cryoprecipitate therapy is variable, and that cryoprecipitate therapy does not achieve restoration of normal hemostasis in some patients with uremic bleeding.
Bleeding Time↗
Transfusion-induced immunomodulation and its possible role in cancer recurrence and perioperative bacterial infection.
Over the last decade, it has become evident that homologous transfusions carry immunologic consequences beyond the well-understood ones of alloimmunization to blood cell antigens. Transfusions constitute temporary transplants of large amounts of allogeneic antigen given intravenously and cause down-regulation of many cellular immune functions. These changes may explain in part the association of transfusion with such clinically important events as (1) improved survival of renal allografts, (2) decreased recurrence rates for autoimmune disease, (3) increased frequency and earlier recurrences of solid tumors, (4) increased frequency of post-operative bacterial infection, and (5) increased severity of viral infection. Preliminary data suggest that, in animal models and clinical settings, syngeneic or autologous transfusions are not associated with such events. This finding supports the hypothesis that these associations are cause and effect and involve immunologic mechanisms.
Autoantibodies↗
Comparison of quantitative acid-elution technique and flow cytometry for detecting fetomaternal hemorrhage.
A study of the Kleihauer-Betke acid-elution technique for quantitating fetomaternal hemorrhage was performed to assess intra- and inter-technologist accuracy and precision as well as to delineate the statistically valid domain of the test as usually performed. The results were then compared to a parallel study quantitating fetomaternal hemorrhage by flow cytometry. Additionally, a statistical model for estimating efficacy of treatment with Rh immune globulin in the prevention of pregnancy-associated Rh(D) isoimmunization was developed. The results indicate that the acid-elution technique can be performed in a reproducible manner with acceptable accuracy and precision with whole blood fetomaternal hemorrhages 25 ml and higher if a background correction for false positive identification of fetal cells is included. Flow cytometric determination reveals significantly increased accuracy in comparison to the corresponding Kleihauer-Betke results.
Adult↗
A possible association between survival time and transfusion in cervical cancer.
Some studies suggest that transfusion may be associated with an increased risk of recurrence of and death due to malignant human neoplasms. We examined retrospective data from patients with cervical cancer to see if any association between transfusion of blood at the time of initial treatment and the time interval to recurrence and death could be detected in this cancer. In 130 patients with cervical cancer, seen over a ten-year period at our institution, there was a trend toward earlier recurrence in transfused patients, but this trend did not achieve statistical significance. Death due to cervical cancer recurrence occurred after a median of Death due to cervical cancer recurrence occurred after a median of 12 months in the transfused patients and a median of 68 months in the non-transfused individuals, which was statistically significant. Transfused patients had, on average, more favorable prognostic factors than those not transfused, such as less advanced clinical stage of disease. Analysis using a proportional hazards risk model failed to demonstrate a significant association between transfusion and time to recurrence when other prognostic factors were considered, but a significant association between transfusion and time to cancer-related death (p less than 0.05) was found. While these results cannot be viewed as conclusive due to the small number and heterogeneity of the patients analyzed, our data support the possibility of an association between transfusion and cervical cancer survival. Further studies are warranted to confirm or refute this relationship.
Blood Transfusion↗
Clinical correlates in patients with elevated platelet-associated immunoglobulins.
Studies are reported pertaining to platelet-associated IgG (PAIgG) and IgM (PAIgM) in patients with thrombocytopenias considered possibly immune-mediated on clinical grounds. Approximately 14 percent of all patients with these disorders had elevated PAIgM but normal levels of PAIgG. Of patients with classic autoimmune thrombocytopenia (ITP), there was a trend toward more frequently normal levels of PAIgG in chronic ITP compared with patients with acute ITP, but this was not statistically significant. Patients with acute ITP had higher levels of PAIgG and PAIgM in general than those with chronic ITP. Patterns of PAIgG and/or PAIgM elevation were not significantly different when chronic and acute ITP were compared, nor when childhood ITP was compared with adult ITP. Patients with immune thrombocytopenias owing to malignant disorders were likely to have lower levels of PAIgG compared with those with classic ITP. Treated patients with immune thrombocytopenias showed a trend toward earlier response to therapy if they had only elevated PAIgG as opposed to elevated PAIgM alone or elevated PAIgM and PAIgG (p = 0.17). There appear to be great overlaps in the patterns and quantities of PAIgG and PAIgM in patients with immune-mediated thrombocytopenias in widely varied clinical settings. This suggests some underlying common pathophysiologic mechanisms for thrombocytopenia in these clinically diverse disorders. It is believed that the data are most consistent with the hypothesis that thrombocytopenia in patients with elevated PAIgG and/or PAIgM is most probably of immune origin even in such diverse disorders as systemic lupus erythematosus, cirrhosis of the liver, lymphoma, leukemia, cancer, or septic conditions, as well as in ITP.
Adult↗
The type and screen: are patient charges a valid measure of cost reduction?
Previous studies of the type and screen have employed reduction in patient charges as a measure of cost savings. Actual cost reductions were estimated as well as patient charge reductions, for the type and screen in a large university medical center with 38,519 cross-matches and 18,152 red cell containing transfusions (C/T = 2.12) in 1980. If the type and screen had been implemented for elective surgical procedures with C/T greater than 2, the C/T for these services would have fallen from 2.82 to 2.17. If use of the type and screen were extended to obstetrics patients, the total surgical and obstetrical patient charges would be reduced by $51,752, but only $9,232 or less in actual cost reduction would have accrued. The type and screen does not lead to significant decreases in labor or overhead costs which are the largest component of patient charges. Patient charge savings are not a valid measure of actual cost reduction in our setting.
ABO Blood-Group System↗
Analysis of two types of granulocyte transfusions in patients with acute leukemia and septicemia.
In a study of 300 patient episodes where filtration granulocytes or centrifuged granulocytes were transfused to neutropenic patients with fever, 81 cases of culture proven septicemia in patients with acute leukemia were analyzed. Age, sex, organisms, interval between fever and transfusion, average number of transfusion, and antibiotics were similar in the two groups. Centrifuged granulocytes produced a statistically significantly better recovery rate when compared with filtration granulocytes.
Acute Disease↗