No abstract

Dexamethasone (4-8 mg/m2 body surface area) was given orally or intravenously to six normal volunteers. The maximum neutrophil count occurred 4-6 h after oral or intravenous administration of dexamethasone and was due almost entirely to an increase in mature neutrophils; concomitantly there was a lymphocytopenia. A second rise in the neutrophil count occurred 24 h after oral ingestion of dexamethasone, coinciding with a lymphocytosis. Neutrophil alkaline phosphatase (NAP) activity during development fell as the neutrophil count rose. Other haematological values were unchanged except for small increments in erythrocyte sedimentation rate (ESR). Sodium concentration in serum and urine remained normal but urinary potassium excretion and urine volume increased after the intravenous dose. There was a direct relationship between plasma concentration of dexamethasone and the rise in neutrophil count following intravenous but not oral administration. The concentration of dexamethasone in plasma fell to half its peak value in 2-6 h. Dexamethasone-induced neutrophilia was similar to that induced by other corticosteroids. Dexamethasone in a dose of 6 mg/m2 produced minimal discomfort while inducing an adequate neutrophilia in the volunteers.

A reduction of donor effects during centrifugal plateletpheresis with the Haemonetics Blood Processor was achieved by reducing the concentration of the citrate anticoagulant. Serum citrate and ionized calcium levels, immediately and 1 h post-pheresis, were affected to a lesser extent by using 5.0 g total ionized citrate (TIC) THAN WITH EITHER 8.0 G OR 11.0 G. Total calcium, bicarbonate, prothrombin time, partial thromboplastin time, ECG, and platelet counts were affected to a similar degree by all three TIC formulations. The total number of platelets collected per litre of blood processed was not significantly different among the three TIC formulations. In vitro studies employing the screen filtration pressure (SFP) technique showed no evidence of platelet aggregates in whole blood collected into either 0.01 M or 0.005 M citrate and agitated or left stationary at room temperature for 5 h. The use of different citrate concentrations in plateletpheresis is discussed.

A total of 67 leukaphereses were performed with the IBM blood cell separator (BCS) on 50 healthy donors for the pu'pose of obtaining a clinically useful number of granulocytes for infusion into patients with acute leukemia and granulocytopenia accompanied by severe infection. The pretreatment of donors with dexamethasone and the addition of hydroxyethyl starch (HES) to the input line of the BCS significantly increased the total number of granulocytes collected, as compared to the total number of granulocytes harvested either by dexamethasone pretreatment only or by the absence of dexamethasone and HES. A mean of 2.03 X 1010, 1.58 X 1010, and 1.07 X 1010 total granulocytes was collected by the HES plus dexamethasone, by dexamethasone alone and with neither HES or dexunethasone, respectively. The efficiency of cell collection, as evidenced by the total number of granulocytes harvested per liter of blood processed, wag also significantly improved by the combined use of HES and dexamethasone. The results of the p r e n t study demonstratrs that a clinically useful number of granulocytes can be harvested and made available for supportive therapy to patients experiencing granulocytopenia causrd by malignant disease or its treatment. SEPSIS and other severe infections are the major contributors of morbidity and mortality in patients with acute leukemia.6. 9 Several supportive therapeutic techniques have evolved, such as treatment with antibiotic combinations, whole blood and platelet transfusions, and uricosuric therapy, in addition to conventional chemotherapy. Administration of leukocyte transfusions and sterilization of the gastrointestinal tract in germ-free units are presently under

A total of 67 leukaphereses were performed with the continuous-flow centrifuge (CFC) on 27 healthy donors for the purpose of obtaining increased yields of granulocytes for infusion into septic patients with acute leukemia accompanied by severe granulocytopenia. The addition of hydroxyethyl starch (HES) to the input line of the CFC significantly (p < 0.005) increased the total number of leukocytes and/or granulocytes collected per donation. A mean yield of 9.72 x 109 and 4.65 x 109 total granulocytes were collected by the HES-treated and control-group donors, respectively. The efficiency of cell collection as evidenced by the total number of leukocytes and/or granulocytes harvested per liter of processed blood was also significantly (p < 0.005) improved by the addition of HES to the continuous-flow centrifuge. Significant alterations in hematologic parameters were not experienced by HES-treated donors undergoing initial and multiple procedures. Pre- and postdonation leukocyte and platelet counts, hemoglobin, prothrombin time, partial thromboplastin time, and leukocyte differential counts were no different whether or not HES was employed for granulocyte collection. The results of the present study demonstrate that increased yields of granulocytes can be harvested by the addition of HES to the continuous-flow centrifuge and made available for supportive therapy to patients experiencing granulocytopenia induced by malignant disease or its treatment.