The function and structure of granulocytes collected using the IBM 2997 separator

Abstract

The effect of oral methylprednisolone and the sedimenting agent, hydroxyethyl starch, on granulocyte recovery, morphology, and function was studied in a volunteer donor programme. Using the IBM 2997, 10 litres of whole blood were processed, with an average procedure time of 2.4 hours and a collection volume of 300 ml. Donors not receiving methylprednisolone (n = 80) had a mean total granulocyte count of 3.5 X 10(9)/litre (range 1.6-5.3 X 10(9)/litre) and mean granulocyte yields were 1 X 10(10) (range 0.2-3.0 X 10(10)). Those receiving 48 mg oral methylprednisolone 6-8 hours before the procedure (n = 320) had a mean granulocyte count of 6.3 X 10(9)/litre (range 3.2-11.4 X 10(9)/litre) and significantly superior mean granulocyte yields of 2.0 X 10(10) (0.3-6.5 X 10(10)) (P less than 0.05). For both groups the mean packed cell volume of 0.08 litre/litre (range 0.02-0.17) and platelet contamination 1.9 X 10(11) (range 0.3-5.0 X 10(11)). In all these procedures, hydroxyethyl starch was added to the blood entering the centrifuge channel. In none of the procedures were any untoward symptoms experienced by the donors. Light microscopy and ultrastructural studies showed no difference between control granulocytes and those collected following the addition of hydroxyethyl starch or after oral methylprednisolone. Similarly, granulocyte function measured with a random migration, chemotaxis, phagocytosis, and intracellular killing was not significantly different between control cells and those exposed to the sedimenting agent or the adrenocorticosteroids (P greater than 0.10). It is concluded that donor premedication with methylprednisolone significantly enhances granulocyte yields in the presence of hydroxyethyl starch and neither agent has any demonstrable effect on granulocyte morphology or function.

In adult acute nonlymphoblastic leukaemia extended maintenance chemotherapy has no benefit

“…Although we are unable to explain these differences, neither the low white cell count or percentage blasts were statistically significant (P > 0.05), whereas the low platelet count was (P < 0.05), and this finding accords with the experience of others [52], but the strength of this predictive factor appears to be decreasing [41]. A finding of interest, which contrasts with our previous report [7], is that only one of the present series of patients died hypoplastic and this is considered to reflect improvement in the quality of support now available [34,35]. It is necessary to consider an alternative explanation in that the chemotherapeutic regimen may be too toxic for this particular subset of patients.…”

“…Clinical deterioration in a patient having sustained fever greater than 38.5"C, unresponsive to appropriate intravenous antibiotic therapy and less than 0.5 x lo9/ litre granulocytes, received white cell support [34]. Thrombocytopenia with purpuric bleeding was treated with platelet infusions [35].…”