Experience with protein A-immunoadsorption in treatment-resistant adult immune thrombocytopenic purpura.

Abstract:

:Extracorporeal immunoadsorption of plasma to remove IgG and circulating immune complexes (CIC) was evaluated as a therapy for adults with treatment-resistant immune thrombocytopenic purpura (ITP). Seventy-two patients with initial platelet counts less than 50,000/microL who had failed at least two other therapies were studied. They received an average of six treatments of 0.25 to 2.0 L plasma per procedure over a 2- to 3-week period using columns of staphylococcal protein A-silica (PROSORBA immunoadsorption treatment columns; IMRE Corp, Seattle, WA). The treatments caused an acute increase in the platelet count to greater than 100,000/microL in 18 patients and to 50,000 to 100,000/microL in 15 patients. The median time to response was 2 weeks. Responses were transient (less than 1 month duration) in seven of those patients (10%), but no additional relapses were reported over a follow-up period of up to 26 months (mean of 8 months). Clinical responses were associated with significant decreases in specific serum platelet autoantibodies (including anti-glycoprotein IIb/IIIa), platelet-associated Ig, and CIC. Thirty percent of treatments were associated with transient mild to moderate side effects usually presenting as a hypersensitivity-type reaction. Continued administration of failed therapies for ITP, which always included low-dose corticosteroids (less than or equal to 30 mg/d), had no demonstrable influence on the effectiveness of immunoadsorption treatment but did depress the incidence and severity of side effects. The degree of effectiveness of protein A immunoadsorption therapy in patients with treatment-resistant ITP is promising and further controlled studies in this patient population are warranted.

journal_name

Blood

journal_title

Blood

authors

Snyder HW Jr,Cochran SK,Balint JP Jr,Bertram JH,Mittelman A,Guthrie TH Jr,Jones FR

subject

Has Abstract

pub_date

1992-05-01 00:00:00

pages

2237-45

issue

9

eissn

0006-4971

issn

1528-0020

journal_volume

79

pub_type

临床试验,杂志文章,多中心研究

相关文献

BLOOD文献大全
  • Enasidenib in mutant IDH2 relapsed or refractory acute myeloid leukemia.

    abstract::Recurrent mutations in isocitrate dehydrogenase 2 (IDH2) occur in ∼12% of patients with acute myeloid leukemia (AML). Mutated IDH2 proteins neomorphically synthesize 2-hydroxyglutarate resulting in DNA and histone hypermethylation, which leads to blocked cellular differentiation. Enasidenib (AG-221/CC-90007) is a firs...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood-2017-04-779405

    authors: Stein EM,DiNardo CD,Pollyea DA,Fathi AT,Roboz GJ,Altman JK,Stone RM,DeAngelo DJ,Levine RL,Flinn IW,Kantarjian HM,Collins R,Patel MR,Frankel AE,Stein A,Sekeres MA,Swords RT,Medeiros BC,Willekens C,Vyas P,Tosolini A

    更新日期:2017-08-10 00:00:00

  • Bernard-Soulier syndrome caused by a dinucleotide deletion and reading frameshift in the region encoding the glycoprotein Ib alpha transmembrane domain.

    abstract::We investigated the molecular genetic and biosynthetic basis of Bernard-Soulier syndrome in a severely affected white woman. Flow cytometric analysis showed a severe deficiency of glycoprotein (GP) Ib, GP IX, and GP V on the surface of her platelets. Similarly, GP Ib alpha was undetectable by immunoblot analysis of pl...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Afshar-Kharghan V,López JA

    更新日期:1997-10-01 00:00:00

  • Enhanced immune activity of cytotoxic T-lymphocyte epitope analogs derived from positional scanning synthetic combinatorial libraries.

    abstract::The pp65(495-503) cytotoxic T-lymphocyte (CTL) epitope from cytomegalovirus (CMV) is universally recognized among CMV+ individuals who express an allele of the human leukocyte antigen A (HLA-A*0201). The relative binding affinity of the epitope to HLA-A*0201 is moderate, and its increased activity might prove benefici...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood.v97.6.1776

    authors: La Rosa C,Krishnan R,Markel S,Schneck JP,Houghten R,Pinilla C,Diamond DJ

    更新日期:2001-03-15 00:00:00

  • Positive and negative regulation of granulocyte-macrophage colony-stimulating factor promoter activity by AML1-related transcription factor, PEBP2.

    abstract::The granulocyte-macrophage colony-stimulating factor (GM-CSF) gene promoter contains a consensus sequence for the polyomavirus enhancer binding-protein 2 (PEBP2) transcription factor, which consists of alpha and beta subunits. There are at least two genes, alpha A and alpha B, encoding the alpha subunit. alpha B is th...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Takahashi A,Satake M,Yamaguchi-Iwai Y,Bae SC,Lu J,Maruyama M,Zhang YW,Oka H,Arai N,Arai K

    更新日期:1995-07-15 00:00:00

  • Relationship between minimal residual disease and outcome in adult acute lymphoblastic leukemia.

    abstract::In children with acute lymphoblastic leukemia (ALL), the level of minimal residual disease (MRD) at the end of induction strongly predicts outcome, presumably because it measures both drug sensitivity and the number of leukemic cells requiring elimination. Children with high levels (> 10(-3) leukemic cells per marrow ...

    journal_title:Blood

    pub_type: 临床试验,杂志文章,多中心研究

    doi:

    authors: Brisco J,Hughes E,Neoh SH,Sykes PJ,Bradstock K,Enno A,Szer J,McCaul K,Morley AA

    更新日期:1996-06-15 00:00:00

  • Drug-induced thrombocytopenia: development of a novel NOD/SCID mouse model to evaluate clearance of circulating platelets by drug-dependent antibodies and the efficacy of IVIG.

    abstract::Drug-induced immune thrombocytopenia (DITP) is an adverse drug effect mediated by drug-dependent antibodies. Intravenous immunoglobulin (IVIG) is frequently used to treat DITP and primary immune thrombocytopenia (ITP). Despite IVIG's proven beneficial effects in ITP, its efficacy in DITP is unclear. We have establishe...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood-2010-02-268326

    authors: Liang SX,Pinkevych M,Khachigian LM,Parish CR,Davenport MP,Chong BH

    更新日期:2010-09-16 00:00:00

  • Erythroblasts are a source of angiogenic factors.

    abstract::In adult bone marrow, mature erythroblasts are produced within structures called erythroblastic islands and then cross the endothelial barrier to reach circulation. Erythroblastic islands are composed of a central macrophage surrounded by maturing erythroblasts. In this study, it is shown that erythroid cells, but not...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood.v97.7.1968

    authors: Tordjman R,Delaire S,Plouët J,Ting S,Gaulard P,Fichelson S,Roméo PH,Lemarchandel V

    更新日期:2001-04-01 00:00:00

  • Analysis of the clonal growth and differentiation dynamics of primitive barcoded human cord blood cells in NSG mice.

    abstract::Human cord blood (CB) offers an attractive source of cells for clinical transplants because of its rich content of cells with sustained repopulating ability in spite of an apparent deficiency of cells with rapid reconstituting ability. Nevertheless, the clonal dynamics of nonlimiting CB transplants remain poorly under...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood-2013-06-508432

    authors: Cheung AM,Nguyen LV,Carles A,Beer P,Miller PH,Knapp DJ,Dhillon K,Hirst M,Eaves CJ

    更新日期:2013-10-31 00:00:00

  • BCL-2 expression and mitochondrial activity in leukemic cells with different sensitivity to glucocorticoid-induced apoptosis.

    abstract::The present study investigates the relationship between mitochondrial activity and the expression of the BCL-2 gene in a panel of six human and murine leukemia/lymphoma cell lines. The cell lines all contained normal glucocorticoid receptors but differed widely in sensitivity to dexamethasone, ranging from very sensit...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Smets LA,Van den Berg J,Acton D,Top B,Van Rooij H,Verwijs-Janssen M

    更新日期:1994-09-01 00:00:00

  • Functions of BET proteins in erythroid gene expression.

    abstract::Inhibitors of bromodomain and extraterminal motif proteins (BETs) are being evaluated for the treatment of cancer and other diseases, yet much remains to be learned about how BET proteins function during normal physiology. We used genomic and genetic approaches to examine BET function in a hematopoietic maturation sys...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood-2014-10-607309

    authors: Stonestrom AJ,Hsu SC,Jahn KS,Huang P,Keller CA,Giardine BM,Kadauke S,Campbell AE,Evans P,Hardison RC,Blobel GA

    更新日期:2015-04-30 00:00:00

  • Enhancement of in vitro beta-thalassemic and normal hematopoiesis by a noncytotoxic monoclonal antibody, 9.1C3: evidence for negative regulation of hematopoiesis by monocytes and natural killer cells.

    abstract::The enhancement of in vitro human hematopoiesis by the addition of a noncytotoxic monoclonal antibody, 9.1C3, is described. Enhancement of all aspects of in vitro hematopoiesis was observed on addition of 9.1C3 antibody to cultures of mononuclear cells from normal bone marrow, cord blood, and peripheral blood from bet...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Kannourakis G,Johnson GR,Begley CG,Werkmeister JA,Burns GF

    更新日期:1988-10-01 00:00:00

  • Tyrosine phosphorylation of guanosine triphosphatase activating protein by activation via surface IgG in human B cells.

    abstract::In this study, we analyzed tyrosine phosphorylation of guanosine triphosphatase (GTPase) activating protein in human B cells stimulated through surface IgG, using Western blot and immunoprecipitation. Stimulation through surface IgG induced the tyrosine phosphorylation of GTPase-activating protein (GAP) and two associ...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Yagura H,Oyaizu N,Pahwa S

    更新日期:1993-03-15 00:00:00

  • Concomitant granulocyte colony-stimulating factor and induction chemoradiotherapy in adult acute lymphoblastic leukemia: a randomized phase III trial.

    abstract::This prospective multicenter study examined whether simultaneous administration of granulocyte colony-stimulating factor (G-CSF; Filgrastim) and induction chemotherapy for adult acute lymphoblastic leukemia (ALL) could prevent treatment-related neutropenia, infections, and resulting treatment delays. Seventy-six patie...

    journal_title:Blood

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:

    authors: Ottmann OG,Hoelzer D,Gracien E,Ganser A,Kelly K,Reutzel R,Lipp T,Busch FW,Schwonzen M,Heil G

    更新日期:1995-07-15 00:00:00

  • Vaccine-delivered HIV envelope inhibits CD4(+) T-cell activation, a mechanism for poor HIV vaccine responses.

    abstract::The human immunodeficiency virus (HIV) causes impairment of the immune system in part by targeting CD4(+) T cells for infection and dysfunction. HIV envelope (Env) present on free virions and infected cells causes dysfunction of uninfected bystander CD4(+) T cells via interaction with both CD4 and coreceptors. Env is ...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood-2006-08-038661

    authors: Fernando K,Hu H,Ni H,Hoxie JA,Weissman D

    更新日期:2007-03-15 00:00:00

  • Development and characterization of a physiologically relevant model of lymphocyte migration in chronic lymphocytic leukemia.

    abstract::There is growing evidence that lymphocyte trafficking contributes to the clinical course of chronic lymphocytic leukemia (CLL), but to date, only static in vitro cultures have been used to study these phenomena. To address this lack of data, we have developed a dynamic in vitro model in which CLL cells experience shea...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood-2013-12-544569

    authors: Walsby E,Buggins A,Devereux S,Jones C,Pratt G,Brennan P,Fegan C,Pepper C

    更新日期:2014-06-05 00:00:00

  • Inhibitory effect of the transcription factor encoded by the mutant mi microphthalmia allele on transactivation of mouse mast cell protease 7 gene.

    abstract::The transcription factor encoded by the mi locus (MITF) is a transcription factor of the basic-helix-loop-helix zipper protein family. Mice of mi/mi genotype express a normal amount of abnormal MITF, whereas mice of tg/tg genotype do not express any MITFs due to the transgene insertional mutation. The effect of normal...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood.v97.3.645

    authors: Ogihara H,Morii E,Kim DK,Oboki K,Kitamura Y

    更新日期:2001-02-01 00:00:00

  • CHAI and LATAIE: new genetic diseases of CTLA-4 checkpoint insufficiency.

    abstract::CTLA-4 is a critical inhibitory "checkpoint" molecule of immune activation. Several recent reports have described patients with immune dysregulation and lymphoproliferative disease resulting from 2 different genetic diseases that directly or indirectly cause CTLA-4 deficiency. Numerous articles have also been publishe...

    journal_title:Blood

    pub_type: 杂志文章,评审

    doi:10.1182/blood-2016-04-712612

    authors: Lo B,Fritz JM,Su HC,Uzel G,Jordan MB,Lenardo MJ

    更新日期:2016-08-25 00:00:00

  • Treatment of adult acute lymphoblastic leukemia with intensive cyclical chemotherapy: a follow-up report.

    abstract::We treated 109 patients with adult acute lymphoblastic leukemia (ALL) diagnosed by histochemical and immunologic techniques. Patients were excluded only for age greater than 50 years and Burkitt's leukemia. Treatment included a four-drug remission induction phase followed by alternating cycles of noncrossresistant che...

    journal_title:Blood

    pub_type: 临床试验,杂志文章

    doi:

    authors: Linker CA,Levitt LJ,O'Donnell M,Forman SJ,Ries CA

    更新日期:1991-12-01 00:00:00

  • Neutrophil and monocyte adherence to and migration across monolayers of cytokine-activated endothelial cells: the contribution of CD18, ELAM-1, and VLA-4.

    abstract::Pretreatment of endothelial cells with cytokines enhances the adherence of leukocytes, a process that is mediated by surface proteins expressed on both cell types. A three-dimensional model system for the simultaneous determination of leukocyte adherence and migration was used to study the contribution of CD11/CD18, e...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Hakkert BC,Kuijpers TW,Leeuwenberg JF,van Mourik JA,Roos D

    更新日期:1991-11-15 00:00:00

  • Acquisition of the V617F mutation of JAK2 is a late genetic event in a subset of patients with myeloproliferative disorders.

    abstract::An acquired gain-of-function mutation in the Janus kinase 2 (JAK2-V617F) is frequently found in patients with myeloproliferative disorders (MPDs). To test the hypothesis that JAK2-V617F is the disease-initiating mutation, we examined whether all cells of clonal origin carry the JAK2-V617F mutation. Using allele-specif...

    journal_title:Blood

    pub_type: 临床试验,杂志文章

    doi:10.1182/blood-2005-11-009605

    authors: Kralovics R,Teo SS,Li S,Theocharides A,Buser AS,Tichelli A,Skoda RC

    更新日期:2006-08-15 00:00:00

  • Biomarkers for prediction of venous thromboembolism in cancer.

    abstract::Cancer patients are at increased risk of deep vein thrombosis and pulmonary embolism. The incidence among different groups of cancer patients varies considerably depending on clinical factors, the most important being tumor entity and stage. Biomarkers have been specifically investigated for their capacity of predicti...

    journal_title:Blood

    pub_type: 杂志文章,评审

    doi:10.1182/blood-2013-04-460147

    authors: Pabinger I,Thaler J,Ay C

    更新日期:2013-09-19 00:00:00

  • Circulating blood B cells in multiple myeloma: analysis and relationship to circulating clonal cells and clinical parameters in a cohort of patients entered on the Eastern Cooperative Oncology Group phase III E9486 clinical trial.

    abstract::Recent analyses of circulating blood B cells in myeloma have generated controversy concerning the exact levels of these cells and whether they may represent circulating clonal tumor B cells. Previous reports suggested that CD19+ B cells are markedly increased in myeloma patients and that this population shares clonoty...

    journal_title:Blood

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:

    authors: Kay NE,Leong T,Kyle RA,Greipp P,Billadeau D,Van Ness B,Bone N,Oken MM

    更新日期:1997-07-01 00:00:00

  • The vascular endothelial-cadherin promoter directs endothelial-specific expression in transgenic mice.

    abstract::Vascular endothelial-cadherin (VE-cadherin) is a calcium-dependent adhesive molecule, exclusively and constitutively expressed in endothelial cells. Analysis of the VE-cadherin promoter fused to a reporter gene in bovine aortic endothelial cells showed three major functional regions. The proximal region alone (-139, +...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Gory S,Vernet M,Laurent M,Dejana E,Dalmon J,Huber P

    更新日期:1999-01-01 00:00:00

  • Dependence on glutamine uptake and glutamine addiction characterize myeloma cells: a new attractive target.

    abstract::The importance of glutamine (Gln) metabolism in multiple myeloma (MM) cells and its potential role as a therapeutic target are still unknown, although it has been reported that human myeloma cell lines (HMCLs) are highly sensitive to Gln depletion. In this study, we found that both HMCLs and primary bone marrow (BM) C...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood-2016-01-690743

    authors: Bolzoni M,Chiu M,Accardi F,Vescovini R,Airoldi I,Storti P,Todoerti K,Agnelli L,Missale G,Andreoli R,Bianchi MG,Allegri M,Barilli A,Nicolini F,Cavalli A,Costa F,Marchica V,Toscani D,Mancini C,Martella E,Dall'Asta V

    更新日期:2016-08-04 00:00:00

  • Biologic and molecular effects of granulocyte colony-stimulating factor in healthy individuals: recent findings and current challenges.

    abstract::Recombinant human granulocyte colony-stimulating factor (rhG-CSF) is widely used in healthy donors for collection of peripheral blood progenitor cells (PBPCs) for allogeneic transplantation and granulocytes for transfusion. The spectrum of its biologic and molecular activities in healthy individuals is coming into sha...

    journal_title:Blood

    pub_type: 杂志文章,评审

    doi:10.1182/blood-2007-07-097543

    authors: Anderlini P,Champlin RE

    更新日期:2008-02-15 00:00:00

  • Mutations of the N-ras gene in juvenile chronic myelogenous leukemia.

    abstract::Juvenile chronic myelogenous leukemia (JCML), a myeloproliferative disorder of childhood, is distinct from adult-type chronic myelogenous leukemia (CML) and bears resemblance to chronic myelomonocytic leukemia (CMMoL). Since mutations in the N-ras gene have been found at high frequencies in CMMoL, but only rarely in C...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Miyauchi J,Asada M,Sasaki M,Tsunematsu Y,Kojima S,Mizutani S

    更新日期:1994-04-15 00:00:00

  • The amino-terminal 29- and 72-Kd fragments of fibronectin mediate selective monocyte recruitment.

    abstract::Proteolytic fragments of fibronectin (Fn) can possess properties not inherent to intact Fn. Previously, only mixtures of low molecular weight Fn fragments, and the 120-Kd fibroblastic cell-binding segment, but not intact Fn, were shown to be selectively chemotactic for human monocytes (MOs). In order to determine if o...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Lohr KM,Kurth CA,Xie DL,Seyer JM,Homandberg GA

    更新日期:1990-11-15 00:00:00

  • Polyamine concentrations in bone marrow aspirates of children with leukemia and other malignancies.

    abstract::High-pressure liquid chromatography analysis of polyamines in bone narrow from leukemic and nonleukemic subjects demonstrated increased concentrations of putrescine, spermidine, and spermine associated with increased cellularity. The most striking abnormality was the marked elevation of putrescine. Bone marrow polyami...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Rennert O,Miale T,Shukla J,Lawson D,Frias J

    更新日期:1976-04-01 00:00:00

  • Hematologic effects of stem cell factor in vivo and in vitro in rodents.

    abstract::Recombinant rat stem cell factor (rrSCF) administered to rats as a single intravenous injection causes a dose-dependent neutrophilia and lymphocytosis as well as the appearance of immature myeloid cells and occasional blast cells in the circulation. Neutrophilia begins at 2 hours, peaks at 4 to 6 hours, and subsides b...

    journal_title:Blood

    pub_type: 杂志文章

    doi:

    authors: Ulich TR,del Castillo J,Yi ES,Yin S,McNiece I,Yung YP,Zsebo KM

    更新日期:1991-08-01 00:00:00

  • Safety of anticoagulants in children with arterial ischemic stroke.

    abstract::Pediatric arterial ischemic stroke (AIS) is increasingly diagnosed and carries significant risks of recurrence, morbidity, and mortality. Anticoagulant therapy (ACT) is commonly prescribed in childhood AIS. Hemorrhagic complication rates in pediatric stroke are unknown, and adult safety data are of limited applicabili...

    journal_title:Blood

    pub_type: 杂志文章

    doi:10.1182/blood-2011-06-361535

    authors: Schechter T,Kirton A,Laughlin S,Pontigon AM,Finkelstein Y,MacGregor D,Chan A,deVeber G,Brandão LR

    更新日期:2012-01-26 00:00:00