Beitrage zur Infusionstherapie = Contributions to infusion therapy最新文献

In plateletpheresis, new single-needle techniques have been developed for the cell separators A 201 (Baxter) and AS 104 (Fresenius). These new techniques were studied concerning donation time, ACD consumption, platelet yield, separation efficiency, erythrocyte and leukocyte contamination. The total amount of thrombocytes and the separation efficiency were significantly better with the single-needle version of the AS 104 apparatus than with the A 201 device. The contamination values were significantly lower with the AS 104 machine.

To improve the separation results of peripheral blood stem cells (PBSC), cytokines (GM-CSF, G-CSF or IL3) can be administered to patients. The most important prerequisites for successful PBSC separation are daily monitoring of CD-34-positive cells to determine the separation days and the use of optimized separation programs. To improve the performance of the cell separation, we increased the process volume to more than patients' blood volume and obtained increased MNC and CFU recoveries. In most cases, we collected more cells than the preseparation number of circulating cells. We therefore conclude that large-volume PBSC separation itself mobilizes hematopoietic progenitor cells.

The methods of collection and storage of peripheral blood stem cells are described and the harvesting after conditioning with cytokines and/or myelosuppressive therapy is discussed. It could be demonstrated that the combination of cytostatics and cytokines gives the best yield and enables to collect a sufficient amount of peripheral blood stem cells for a successful engraftment after myeloablative therapy with only few aphereses.

The human factor VIII gene and the human von Willebrand factor gene have been isolated, and were transfected into a mammalian cell line (Chinese Hamster Ovary Cells = CHO Cells). The resulting factor VIII producing cell line was thoroughly characterized. No differences were found in the recombinant factor VIII compared to plasma-derived factor VIII. For factor VIII production the cells are grown in serum-free defined medium, the recombinant factor VIII is purified by immunoaffinity chromatography plus two subsequent ion exchange steps. The absence of human raw materials for production, and a proven titer reduction of > 10(7) in the purification process significantly minimize the risk of virus transmission by the recombinant factor VIII product. Clinical studies both with previously treated and untreated patients have proven the good hemostatic efficacy and virus safety of the recombinant factor VIII. The inhibitor incidence in previously untreated patients is within the expected range for this patient group.

Since several years the frequency of HIV infections among screened blood donors in Baden-Württemberg (a state in southwest Germany) shows no remarkable differences between the German Red Cross donors and the donors of other blood banks. The authors advocate the hypothesis that different HIV rates among donors depend on their social environment. The number of HIV infections expected increases with the size of the donors' places of residence. The donor populations of different blood banks of Baden-Württemberg seem to be equal. Within the framework of epidemiological surveillance, the results of HIV screening of blood donors should be thoroughly analysed.