Biomedical subjects
Publications and source records attributed to R Eckstein.
Peripheral blood derived hematopoietic stem cells (PBSC) have been transplanted successfully to eight patients suffering from different malignancies. The separations were started during chemotherapy-induced cytopenia and large volumes of peripheral blood were processed. Using this separation concept, it was possible in all cases to obtain the stem cell amount necessary for hematopoietic reconstitution.
Underutilization of autologous blood for transfusion is widespread. Our results suggest that this problem could only gradually be corrected, as some patients show insufficient erythropoietic recovery after a predeposit autologous donation.
Platelet transfusion without regard for AB0 compatibility is controversially discussed. Therefore, we studied the success of 136 AB0 compatible and 52 incompatible platelet applications in 37 patients. Our results suggest, that AB0 matching can improve the response of platelet transfusion.
We did crossmatching in 220 transfusions of single donor platelet concentrates using the purchaseable solid phase immunoassay Capture-P (Immucor, Rödermark, FRG), checking posttransfusion response by calculating the corrected count increment (CCI). Our results show that posttransfusion response in transfusions of ABO major incompatible platelet concentrates is virtually reduced only in those transfusions accompanied by a positive crossmatch in Capture-P. As Capture-P can detect IgG antibodies only, positive test results could well be due to a reaction of recipient immune isoagglutinins with ABH antigens expressed on donor platelets, therefore.
For some years, there has been an increasing success in transplanting PBSC instead of autologous bone marrow in patients suffering from leukemic diseases. In healthy cytapheresis donors, we achieved peripheral blood mononuclear cell (PBM) recoveries of 74%, using a discontinuous flow separation technique (Haemonetics V50, Lymphosurge). At the moment, we have collected PBSC from 4 patients (3 AML, 1 ALL) in 28 cytapheresis procedures ranging from 12.9% to 80.1% (mean: 40.1%), whereas stem cell recoveries, defined by CFU-GM, were significantly better (mean: 66%). At present, one of these patients has been transplanted with PBSC alone, receiving 2.11 x 10(8) PBM/kg with 2.8 x 10(4) CFU-GM/kg. His posttransplantation cytopenia was shorter compared to other patients undergoing autologous bone marrow transplantation. The period of disease-free survival is now more than eight months while he is completely reintegrated into social and working life.
Marrow cell concentration is a fundamental requirement when it becomes necessary to remove red blood cells prior to freezing for autologous or ABH-incompatible allogenous marrow transplantation. We compared 5 different separation techniques and two different cell separators (a: Haemonetics V50 and b: IBM/COBE 2997) routinely used for platelet and granulocyte production.
We tested in vitro lymphocyte reactivity using 5 mitogens and 9 antigens, measured lymphocyte and lymphocyte subpopulation counts, granulocyte chemotaxis and adherence in 10 patients with centroblastic-centrocytic lymphoma (CB-CC), 7 patients with centroblastoma (CB) and 88 healthy controls. The control group could be divided into 3 clusters with significantly different lymphocyte reactivity by means of cluster and discrimination analysis (BMDP2N): 21 high-, 18 medium- and 49 low responders. Comparing lymphocyte reactivity of CB-CC and CB patients to each of the 3 immunofunctional different control groups yielded the surprising result that both malignant lymphomas are equivalent to the low responding control group and show a low, but still normal in vitro immune function.
We performed lymphocyte transformation tests using 14 different mitogens and antigens, determined T-cell- and T-cell subpopulation counts (CD3, CD4, CD8), the CD4/8 ratio, granulocyte chemotaxis and granulocyte adherence in 88 healthy controls, 8 patients with immunoblastoma (IB) and 6 patients with lymphoblastoma (LB). Using cluster and discrimination analyses (F-test; t-test) according to the programs of the UCLA (BMDP2N) the control group (n = 88) could be divided into 3 groups with significantly different lymphocyte responses to mitogenic and antigenic stimulation (21 high-, 18 medium, and 49 low responders). Comparing the lymphocyte reactivity of IB and LB patients to these immunofunctional different clusters we found a complete accordance of the lymphoma patients to the healthy low responder group.
Immunofunctional methods are characterized by a great range of variation. Our results suggest, that multivariate experiments and mathematics may improve interpretation.
We studied human blood groups in different nonhuman primates for observing how they were transformed during the different evolutionary stages that eventually led to man. Our results underline that comparative studies of these systems in primates offer a unique tool for the investigation of the development of the principle systems today encountered in man.
We report of a case of a 56 years old female patient who died of severe haemolytic anaemia induced by an injection of a single dose of diclofenac. We suppose that an immune complex reaction caused the haemolytic crisis.
A case of three tumours presenting 44 years following external irradiation to the neck is reported. Whilst thyroid, parotid and parathyroid tumours are all described in this situation, the simultaneous presentation of all three has not been documented previously.
In most centers allogeneic bone marrow transplantation is restricted to patients with HLA-identical siblings as donors. We have transplanted 16 patients with marrow of donors other than HLA-identical siblings. Seven patients were grafted in the years 1978 until 1984. Six died of transplant complications and one of recurrent leukemia. More recently 9 patients were transplanted following an improved immunosuppressive conditioning treatment derived from experimental studies in dogs. Four are alive and in continuous remission between more than 2 months and 2 years. 5 patients died, 3 from fungal infections, one from recurrent leukaemia and one early from endothelial leakage syndrome. Our results indicate that intensified immunosuppressive conditioning may improve the results of marrow transplantation from HLA-haploidentical donors.
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