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Stem Cell Donor Is a Costful and Timely Procedure

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Stem Cell Donor Is a Costful and Timely Procedure P509 to 8 of 10 possible MM occurred: No MM (4%), 1 MM (10%), 2 Cord Blood Bank of the Czech Republic, six month check MM (15%), 3 MM (22%), 4 MM (25%), 5 MM (12%), 6 MM I. Fales, S. Rahmatova, P. Kobylka, S. Matejckova, L. (6%), 7 MM (3%), 8 MM (2%). There was no significant Zahlavova, A. Hruba Institute of Hematology and Blood association between the number of MM (also analysed in Transfusion (Prague, CZ) GvHD or rejection direction) using HR-level for both HLA-A, -B and -DRB1 and HLA-A, B, C, DRB1 and DQB1 and the Cord Blood Bank of the Czech Republic (CCB CR) was incidence of aGvHD grade II-IV. There was a trend that MM in established in the year 1996. But the first collection of the cord class I HR were associated with neutrophil recovery; HLA-A blood (for the related part) in this project was performed in locus typing analysed in rejection direction as well as 1 or 2 A- 1994. It was planned collection for sibling suffering with LAD locus HLA disparities were associated with reduced CI of syndrome. The transplantation of the fully matched graft was engraftment (p= 0.04). The same was observed for the HLA- performed in the same year and it was first transplantation of C-KIR epitopes in rejection (HvG) direction (p=0.01). No the patient with this diagnosis by cord blood on the world. significant correlation was found between numbers of HLA- Actually 3 processing and 28 collection centres are MM on HR level with 2-year survival. Despite the cooperating in this project under management of the Cell heterogeneity and number of patients analysed, it shows that therapy department of the Institute of haematology and blood the actual degree of mismatching is even higher than transfusion. In the related part of the CBB CR 130 graft units previously expected. It also reveals that subtyping for HLA-A, - are stored and 6 graft from them were transplanted. In B, -C and –DQ does not improve the 2-year survival. Thus in unrelated part of the CBB more than 2500 units are stored. CBT most likely subtyping of HLA alleles should not be Information about more than 1600 grafts was submited to the required on a routine basis. Czech Bone Marrow Donors register and by it to the BMDW. From this part of the CBB CR also 6 grafts were transplanted (4 children, 2 adults). From the year 2004 is CBB CR fully P511 valuable NETCORD member. CBB CB consistently performs The chances of finding a 10/10 HLA allele-matched six month check. Without this check the graft is not released unrelated donor are highly predictable for the register. Thanks to this policy has CBB CR delay in J.-M. Tiercy, B. Chapuis, U. Schanz, R. Seger, P. Schneider, releasing of the grafts to register database, but on the other G. Nicoloso, R. Schwabe, A. Gratwohl University Hospital side the quality of the CBB is guranted. For this reason before (Geneva, CH); University Hospital (Zurich, CH); Kindersspital mentioned disproportion between figures of stored and (Zurich, CH); Blood Transfusion Center (Lausanne, CH); released grafts exists. Due to small area of our country and Swiss Bone Marrow Donor Registry (Berne, CH); University still conservative attitude of population to the migration for Hospital (Basel, CH) work, is this six month check very succesfull, more than 93% and probably will be even better. Six month check has two Histocompatibility testing for the identification of a matched part, pediatric evaluation of the child´s health and mother´s unrelated stem cell donor is a costful and timely procedure. blood re-testing for infectious diseases. After six month check Waiting in vain for an ideal donor can delay alternative 0,1 % of the grafts were discarded due to infection of the strategies, e.g. haploidentical HSC transplantation or non- mother, and 0,89% due to pediatric examination of the baby. transplant. In order to improve donor search strategy and So 1% of the grafts were discarded after six month check all to efficiency we introduced in 2002 an estimation of the gether. This check cannot be performed in 3% cases. In 2% probability to identify a 10/10 matched donor, i.e. compatible the mothers were not contacted and in 1% the mothers at the allele-level for HLA-A/B/C/DRB1/B3/B5/DQB1. The refused cooperation. probabilities were classified at initiation of donor search as low (no 10/10 match is expected in the 6-months framework of the search), intermediate (50% chance), or high (100% chance). Of 175 consecutive searches, 32 patients were classified as Stem cell donor having a high, 61 an intermediate, and 82 a low probability to find a 10/10 matched donor. The prediction was correct for 97% (high), 61% (intermediate), and 89% (low) of the patients. The overall positive (high/intermediate probability) and P510 negative (low probability) predictive values were 73% and High-resolution HLA typing by sequencing for HLA-A, B, 89%, respectively. For the 73 patients with a low probability, C, DR, DQ in 122 unrelated cord blood/patient pairs. Does incompatibilities were linked to HLA-C (40%), HLA-DRB1 it improve long-term clinical outcome? (26%, mainly DR4, DR13), and HLA-B (18%) alleles. The B18, G. Kögler, J. Enczmann, V. Rocha, E. Gluckman, P. Wernet B35, B44 and B51 haplotypes accounted for 73% of HLA-C University of Duesseldorf (Duesseldorf, D); Eurocord, Hopital mismatches. The average number of ABDR-identical Saint-Louis (Paris, F) donors/patient in BMDW Registry for each category was 316 (high), 56 (intermediate), and 60 (low). Hence, the number of The CB Bank Düsseldorf has provided to date (November donors was not a reliable parameter to discriminate between 2004) 240 CB units (232 unrelated and 8 related) to transplant low and intermediate probability. The most relevant criteria centers worldwide. To determine the impact of HLA high were individual allele frequencies, B18/B51 haplotypes, resolution (HR) typing with outcomes after unrelated cord phenotypes with <= 2 ABDR antigen-matched donors in blood transplantation (UCBT), DNA samples of 122 CB BMDW Registry, as well as the experience of the HLA recipients and their unrelated CB grafts were analysed for laboratory with unusual B-Cw and DRB1-DRB3 associations. HLA-class I (A, B, C) and -class II (DRB1 and DQB1) – Of the 73 patients with a low probability, 18 were transplanted mismatches based on HR typing. When mismatches (MM) early after diagnosis with a mismatched donor (12 with a 9/10 were analysed for HLA-A, -B based on low resolution-typing donor), and 8 with a haploidentical related donor. These data and -DRB1 based on HR-typing, the following MM situation show that the chance to find or not find a 10/10 allele-matched resulted: No MM (13%), one MM (40%), two MM (36%), three donor is highly predictable. Such a step should be integrated MM (8%), four MM (3%). If the MM for -A and -B alleles early on in the donor search process and in the therapeutic detected by HR-typing were included, the situation was as algorithm. follows: 0 MM (6%), 1 MM (28%), 2 MM (48%), 3MM (11%), 4 MM (6%), 5 MM (1%). When A, B, C, DR and DQ based on HR typing were analysed a higher additional frequency of up S125 P512 P513 Granulocyte donation - yield and donor safety. A In vivo time course of plasmatic levels of retrospective study of 115 collections myeloperoxidase, a biomarker of oxidative stress, after U. Axdorph, A. Sollén-Nilsson, A. Svensson, M. Sjödahl, M. granulocyte colony stimulating factor-induced stem cell Hansson Karolinska University Hospital, Solna (Stockholm, S) mobilisation: profile of safety for the donors F. Morabito, A. Saija, M. Martino, G. Console, A. Taimano, P. Objective: Granulocyte (PMN) transfusions are given to Minciullo, M. Cuzzola, P. Iacopino, S. Gangemi Azienda patients with life-threatening infections, refractory to Ospedaliera (Reggio Calabria, I); University of Messina antimicrobial treatment. The objective was to evaluate yield (Messina, I) and complications in granulocyte donation during a 10 year observation time. When stimulated, neutrophils undergo an oxidative burst Methods: PMN donors were identified through a registry for resulting in the generation of large amounts of superoxide and blood donors. Data concerning G-CSF, blood values, yield, in the release of the heme enzyme MPO, which utilizes H2O2 complications and recent status of the donors were evaluated. to convert chloride to hypochlorous acid. Sustained levels of From 1997, a check-up was done 3 weeks post collection: this oxidant are associated with inflammatory side effects, Hemoglobin (Hb), white blood cell counts (WBC), platelets such as cell injury and tissue damage. Since the (Plt), sodium, potassium, calcium, creatinine. administration of rHuG-CSF followed by the leukapheresis Results: 71 consecutive donors, aged 39 years (median; procedure could induce a condition of oxidative stress, it might range 24-59) were included. 6-7 L of blood was processed. be of interest for the donor to verify whether and when this During the first years, HES 450/0.7 was used as health injurious process is triggered off. The aim of this study sedimentation agent, later replaced by HES 200/0.5. was to assess the in vivo time course of plasmatic MPO levels Stimulation and yield (see Table): Series I. 61 donors were in a group of donors mobilized with rHuG-CSF. Plasmatic given G-CSF 300 ug sc the evening before donation and MPO levels were measured before starting rHuG-CSF hydrocortisone 100 mg iv 15 minutes before collection.
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