Biomedical subjects
Publications and source records attributed to V Weisbach.
Stimulation of lymphocytes with mitogens and antigens is an established model for in vitro testing of immunoreactivity. Due to the great variability of blastogenic response the interpretation of these results is difficult. Our results suggest that multivariate experiments and statistics improve the interpretation.
A 47-year-old man (group A) received a cadaver liver from a group 0 donor. On day 8 after the transplant the recipient developed severe immune hemolysis and showed a positive direct antiglobulin test due to two antibodies (anti-A and anti-P1) of transplant donor origin. The possible mechanisms involved in "autoantibody" formation in the recipient are discussed.
We report a case of an anti-M antibody (titer 128) and MN red blood cells (RBC) in a 76-year-old female German patient. In our case, however, RBC showed weak reactions to human anti-M compared with strong reactions using rabbit anti-M. Papain treatment destroyed the RBC reactivity to human anti-M whereas the strong reactivity to rabbit anti-M was unchanged. This pattern was also demonstrable in the patient's son and grandson. Our results indicate the existence of a rare allele at the MN locus in this family.
Over a period of 20 months we identified 10 voluntary blood donors with indeterminate reactions in anti-HIV 1/2 EIA tests. Western blot (WB) patterns of 6 of these 10 donors showed isolated core antibodies (anti-p24), in 4 cases WB patterns were negative. After a median follow-up period of 58 weeks (range 12-93) we have not seen a case of typical seroconversion.
Forty patients with germ cell tumors were treated with carboplatin 1500-2000 mg/m2, etoposide 1200-1600 mg/m2 and ifosfamide 0-10 g/m2 plus mesna followed by autologous stem cell reinfusion. A pruritic maculopapular rash was observed in 10 patients usually starting on the last day of chemotherapy. Lesions remained localized to the extremities in four patients. In six they became confluent and progressed also involving the trunk and face. Facial edema and painful swelling of hands and feet also occurred in this latter group. No ulcerations or bullae formation were seen and changes resolved spontaneously in all patients within 3 weeks leaving marked hyperpigmentation in involved areas. Renal function declined in nine of 10 patients concomitantly with evolving cutaneous changes, but recovered in all except one. Cutaneous side effects were more frequent with increasing doses of etoposide and carboplatin and in patients with deteriorating renal function. Plasma concentrations during high-dose chemotherapy should be monitored to avoid excessive serum levels and toxicity, especially in patients at risk of renal dysfunction.
We studied platelet loss, leukocyte depletion, T/B-cell-ratio, platelet morphology and platelet function (aggregation, hypotonic shock reaction, retention and retraction) prior to and after filtration through two different polyester filters (Sepacell PL-5A, Pall PL100) as well as the posttransfusional platelet increment 1 h after transfusion in 8 pairs of single donor platelet concentrates (Cobe Spectra, Fresenius AS 104). Leukocyte depletion was effective (greater than 99.9%) and platelet loss acceptable in both filters, all tests showing no indication of a diminished platelet function by filtration.
Autologous blood donation before elective surgery has been widely endorsed as good transfusion practice. Although only 6 percent of patients undergoing elective orthopedic surgery are unable to donate 3 autologous units, 40 percent cannot donate 4 units because they become anemic [1,2]. According to the results of our study this must be due to different problems in bone marrow dynamics, which cannot be overcome by unselected use of human recombinant erythropoietin alone [3].
For some years, there has been an increasing success in transplanting peripheral blood stem cells (PBSC) instead of autologous bone marrow in patients suffering from different malignancies. While collecting PBSC for autologous transplantation, we compared four different separation techniques and three different cell separators (COBE Spectra, Fresenius AS 104, Haemonetics V50) routinely used for platelet production. Our results suggest that continuous flow separators seem to have some advantage over discontinuous flow machines in harvesting PBSC.
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.