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Background and Objectives Autologous haematopoietic progenitor cell ( HPC) is a prerequisite for high-dose chemotherapy in treatment of several haematologic and non-haematologic malignancies. HPCs are collected by apheresis and cryopreserved until infusion. Postinfusion adverse events have been in part related to the dimethyl sulphoxide ( DMSO) used as cryoprotectant. The aim was to evaluate (i) an automated sequential washing procedure for DMSO removal in thawed HPC grafts and (ii) washing solutions in replacement of hydroxyethyl starch ( HES)-based solutions. Materials and Methods A total of 26 HPC bags cryopreserved with 10% DMSO and intended for disposal were used. The Sepax-2 (Biosafe, Eysins, Switzerland) was evaluated using a sequential washing procedure. Outcomes were CD34+ cell recovery and viability after washing. Results The Ringer lactate supplemented or not with albumin 2·5-5% presented satisfactory results compared with HES solution in terms of CD34+ cell recovery and viability after washing. However, the apparition of aggregates led us to renounce to these alternative solutions. Using HES solution and a sequential washing of three bags, we showed the elimination of 95% of the DMSO, a postwash viable CD34+ cell recovery of 79·9 ± 9·4% and a total nucleated cell viability of 66·5 ± 9·3%. Conclusion The preclinical evaluation of an automated sequential washing procedure for DMSO removal in thawed HPC grafts has proven to be effective and comparable to previously published data. Despite our attempt to find an alternative solution to the HES solution, more efforts should be done on this side to reach a consensus on cryopreservation protocols. [ABSTRACT FROM AUTHOR]

Surgical blood loss and trauma are the major causes of allogeneic blood transfusions, which still bear considerable risks. After the correction of hypovolemia, the anesthesiologist often has to deal with normovolemic anemia. The clinical relevance of this isolated decrease in hemoglobin concentration consists in an eventually compromised global or regional oxygen supply with the development of tissue hypoxia below a critical threshold. This is an individual threshold for each patient and depends on his or her capacity to compensate the decrease in blood oxygen content. Therefore, physiologic transfusion triggers should primarily be applied and not rigid numeric transfusion triggers, such as hemoglobin concentration, which do not take into account each patient's individual reserve. [ABSTRACT FROM AUTHOR]

Over a period of 5 years, an isolated light chain (κ = 9, λ = 12) was detected in 21 sera by immunofixation electrophoresis. Further analysis with anti-δ- and anti-∊-specific antisera identified four δ heavy chains, all associated with a λ light chain, and no ∊ heavy chains. For evaluation of the role of two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) in the diagnosis of IgD paraproteins, as a possible alternative or complement to immunofixation. IgD paraproteins were retrospectively analyzed by 2D-PAGE. δ Heavy chains migrated to gel areas clearly distinguishable from other heavy chains α. γ or μ, and in a wide range of isoelectric points (pI: 5,4-8). In one serum, the monoclonal δ chain had a pI range comparable to that of albumin and was undetectable. However, all four δ chains were easily identified when analyzed from affinity-purified immunoglobulin fractions. These observations showed the following: 1) IgD paraproteins are not rare among apparently isolated monoclonal light chains detected by routine immunofixation, strongly confirming the need for further analysis with anti-δ antisera, before assumption of a tight-chain disease. 2) 2D-PAGE analysis of affinity-purified immunoglobulin fractions allowed correct identification of IgD monoclonal gammopathies in all cases. 3) However, although 2D-PAGE analysis is now easy to perform, well standardized, and highly sensitive, this technique remains time-consuming and expensive, and does not appear suitable for routine practice as a first-line diagnostic procedure. 2D-PAGE should find its place as a complement to immunofixation and in the definitive demonstration, in selected ambiguous cases, of the clonal pattern of a suspected gammopathy at immunofixation. [ABSTRACT FROM AUTHOR]

La conservation des concentrés érythrocytaires (CE) pendant 42 jours est primordiale pour la transfusion sanguine mais n’est pas anodine pour les globules rouges qui accumulent des lésions, dites de stockages. Ces altérations sont associées à une diminution du métabolisme, une augmentation de l’oxydation des protéines, au changement de forme, à l’hémolyse et la microvésiculation (MV) et peuvent être classées en tant que réversibles ou irréversibles. Une analyse détaillée montre que les premières apparaissent autour de 2 semaines et les suivantes autour de 4 semaines de conservation. Les lésions irréversibles devraient avoir un impact tout particulier en transfusion, notamment au niveau de l’efficacité transfusionnelle et de l’inflammation (MV et stimulation de cytokines, hémoglobine et fer libre). Si nous considérons les études cliniques, il apparaît que les délais de conservations des CE « jeunes » sont inférieurs à 14 jours et ne sont seulement que de 18 jours pour des CE « vieux ». Prenant en compte l’ensemble de ces données, les risques liés à la transfusion de CE âgés ne semblent pas suffisamment considérés, ajoutant un facteur de plus au débat autour de l’âge des CE. D’un point de vue clinique, il serait donc particulièrement intéressant de reconsidérer l’âge des CE et d’inclure ceux contenants des lésions irréversibles, potentiellement responsable d’inflammations. D’un point de vue plus fondamental, une meilleure connaissance des lésions et une meilleure considération des données analytiques (autre que l’hémolyse et le taux de survie in vivo) sont primordiales pour l’amélioration et le développement de solutions de conservations et pour la gestion des transfusions. [ABSTRACT FROM AUTHOR]

Abstract: Aim of the paper: Arouse the reflection with a fiction having a scientific appearance, presenting a late and unexpected complication of the universal inactivation of pathogens. Conclusion: Such a fiction story opens the debate on a series of fundamental questions that could be addressed during the paradigm shift that is expected by introducing universal pathogen inactivation of blood products. [Copyright &y& Elsevier]

The current issues debate brings together experts around the themes of self-sufficiency (in its national and European aspects) and of needs in cellular blood products. The point of view of the manufacturer and prescribers of blood products are confronted. [ABSTRACT FROM AUTHOR]