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Biomedical subjects

W V Miller

Publications and source records attributed to W V Miller.

60 records · Page 4Linked to original sources

Tissue transplant-transmitted infections.

Tissue bankers, as well as those transplanting tissues, have been sensitized to the possibility of transmission of fatal infection via tissue transplants, particularly following recent reports of a few cases of AIDS or HIV infection from bone, semen, and skin grafts. It is beyond the scope of this review to describe the steps taken by tissue banks to enhance the safety of tissue transplants. Of note is the fact that a number of new donor screening tests, such as those for antibody to HIV, HBcAg, hepatitis C virus, and human T cell lymphotropic virus type I, have recently been implemented. In addition, rapid advances in the medical history screening of tissue donors and tissue procurement, processing, and preservation continue. Viral inactivation studies are also being undertaken. All these measures are being introduced to increase the safety of tissue transplants.

Bacterial Infections↗

Transfusion of donor buffy coat cells in the treatment of persistent or recurrent malignancy after allogeneic bone marrow transplantation.

BACKGROUND: Patients who experience relapse after allogeneic bone marrow transplantation have a poor prognosis. However, preclinical and clinical data have strongly suggested the existence of an immune-mediated anti-tumor effect of allogeneic bone marrow transplantation. This effect, termed graft-versus-leukemia, may be harnessed purposefully in patients with posttransplant relapses by the administration of immune cells obtained by leukapheresis of the original bone marrow donor. STUDY DESIGN AND METHODS: Thirteen patients with persistent or recurrent hematologic malignancy after HLA-matched sibling-donor allogeneic bone marrow transplantation were treated with transfusion of buffy coat cells collected from the original bone marrow donors. Mononuclear cell dose ranged from 1.18 to 4.28 x 10(8) per kg. Alpha-interferon (1.5-3 x 10(6) U/m2 3-5x/week) was given to seven patients. Patients were observed for the development of graft-versus-host disease and disease response. RESULTS: Three of five patients with chronic myelogenous leukemia had complete remissions. One of five patients with active acute leukemia attained complete remission. A sixth acute leukemia patient treated with buffy coat transfusion after the induction of remission with chemotherapy relapsed 12 months later. One patient with myeloma had a complete but transient response. A patient with Hodgkin's disease did not respond. Four patients remain in remission 4, 16, 17, and 29 months after attaining complete remission. Graft-versus-host disease occurred in eight patients, including all of those with a complete response. One patient developed transient pancytopenia. CONCLUSION: The transfusion of donor buffy coat cells has significant anti-tumor activity in patients with relapsed hematologic malignancy after allogeneic bone marrow transplantation. This effect is strongly associated with graft-versus-host disease.

Adolescent↗

Nature of platelet antibody in Evans syndrome: a case report.

The association of autoimmune thrombocytopenia and autoimmune hemolytic anemia (Evans Syndrome) has been recognized previously. Recently the present authors investigated a patient with this disorder. Both IgG and C3d were found on the patient's red cells and the serum contained a polyspecific IgG red cell antibody demonstrable only by the antiglobulin test. IgG antiplatelet antibody was demonstrated on circulating platelets as well as in the serum from the patient by using 125I-staphylococcal Protein A (ISPA) assay. Absorption of serum with normal platelets resulted in removal of platelet antibody, but not the red cell antibody. Furthermore, eluate prepared from platelets sensitized with patient serum contained an IgG antibody directed specifically against platelets, since it did not cross react with red cells. Our data suggest the presence of two distinct antibodies, one directed against platelets and the other against red cells in our patient with Evans Syndrome. Both these antibodies are IgG in nature and belong to subclass other than IgG3 since staphylococcal Protein A (SPA) binds to all subclasses of human IgG except IgG3.

Aged↗