Language：English   Publisher：Transfusion and Apheresis Science  

Background: Evaluating the safety of preoperative autologous blood donation (PAD) and its transfusion is important, especially for young pregnant donors in an era of extremely low incidence of viral transmission. Materials and Methods: Questionnaires were sent to hospitals, and safety information from donation to transfusion was collected and analyzed. Results: Among 2378 obstetrical donors who underwent PAD, 1664 received autologous blood only (autologous group), 146 received allogeneic blood in addition to autologous blood (allogeneic group), and 568 received no transfusion (no transfusion group). Two hundred one of the 2378 patients (8.5 %) experienced adverse events (AEs) during PAD and its transfusion, although most AEs were mild. Even in the no-transfusion group, 8.1 % of patients experienced some AEs. The vasovagal reaction (VVR) rate was 2.6 % (n = 63). Other AE associated with donation developed in 114 patients (4.8 %), and they were the main components of all AEs; 32.5 % of them were unique to obstetric patients. Obstetrical donors with PAD may have disadvantages compared to donors with PAD in other settings. Transfusion reactions (TRs) occurred in 29 (1.2 %) patients. Surprisingly, the number of patients with TRs per unit did not differ significantly between the autologous and allogeneic groups. Conclusion: Considering that most AEs occurred due to donation, PAD in obstetric patients was not beneficial. Moreover, similar TRs rates between the autologous and allogeneic groups did not indicate the priority of autologous blood. PAD should be performed by using a well-established transfusion management system.

DOI： 10.1016/j.transci.2025.104131

Scopus

PubMed

Language：Japanese   Publisher：The Japan Society of Transfusion Medicine and Cell Therapy  

<p>血小板製剤は，採血から検査，製造，各血液センターへの分配を経て供給可能となるのに約1日半かかるとされており，前日午前中までの“予約”が推奨されている．しかしながら献血者からの採血を考えた場合，前日午前中の予約では採血計画への反映には間に合わず，採血済の血小板の分配調整に反映することしかできない．</p><p>当院では2020年4月より，次週1週間の血小板製剤使用量予測を福岡県赤十字血液センターに情報提供する活動を行っている．“予測”の最大のポイントは，1週間分の予測情報を前週木曜日に提示するという点である．これにより，献血者数が多く見込める週末から需要に合わせた採血調整をすることができ，月曜日からの円滑な製剤供給が可能となる．</p><p>今回の評価により，検査室内で完結する省力化した手順であっても，比較的有用性の高い予測が可能であることが確認できた．今後血小板製剤全品培養による細菌スクリーニングが導入されると，血液センターの出庫日は採血2日目から採血4日目に変更となるため，早くに“予測”を情報提供するメリットはさらに大きくなると期待される．</p>

DOI： 10.3925/jjtc.71.30

CiNii Research

Language：English   Publisher：Internal Medicine  

Therapeutic plasma exchange (TPE) is a strategy for treating cold agglutinin disease (CAD) in order to manage hemolytic complications. However, there are no reports of hemolysis during TPE. A 41-year-old man with secondary CAD was unable to undergo initial TPE because of red blood cell agglutination and hemolysis in his extracorporeal circulation. To avoid low temperatures, the patient and extracorporeal circulation were kept warm by covering and heating them, and finally, he was able to successfully receive TPE three times. Although our approach still has room for improvement, our management protocol appears to be an effective treatment modality for such cases.

DOI： 10.2169/internalmedicine.3606-24

Scopus

PubMed

Language：English   Publisher：British Society for Haematology  

For successful chimeric antigen receptor T (CAR-T) cell therapy, CAR-T cells must be manufactured without failure caused by suboptimal expansion. In order to determine risk factors for CAR-T cell manufacturing failure, we performed a nationwide cohort study in Japan and analysed patients with diffuse large B-cell lymphoma (DLBCL) who underwent tisagenlecleucel production. We compared clinical factors between 30 cases that failed (7.4%) with those that succeeded (n = 378). Among the failures, the proportion of patients previously treated with bendamustine (43.3% vs. 14.8%; p < 0.001) was significantly higher, and their platelet counts (12.0 vs. 17.0 × 10⁴/μL; p = 0.01) and CD4/CD8 T-cell ratio (0.30 vs. 0.56; p < 0.01) in peripheral blood at apheresis were significantly lower than in the successful group. Multivariate analysis revealed that repeated bendamustine use with short washout periods prior to apheresis (odds ratio [OR], 5.52; p = 0.013 for ≥6 cycles with washout period of 3–24 months; OR, 57.09; p = 0.005 for ≥3 cycles with washout period of <3 months), low platelet counts (OR, 0.495 per 105/μL; p = 0.022) or low CD4/CD8 ratios (<one third) (OR, 3.249; p = 0.011) in peripheral blood at apheresis increased the risk of manufacturing failure. Manufacturing failure remains an obstacle to CAR-T cell therapy for DLBCL patients. Avoiding risk factors, such as repeated bendamustine administration without sufficient washout, and risk-adapted strategies may help to optimize CAR-T cell therapy for DLBCL patients.

DOI： 10.1111/bjh.18831

Scopus

PubMed

CiNii Research

Language：Japanese   Publisher：(一社)日本血液学会-東京事務局  

実臨床におけるB細胞性急性リンパ芽球性白血病に対するキメラ抗原受容体T(CAR-T)細胞製造成否の状況を明らかにするため,tisagenlecleucel(tisa-cel)製造を実施された81症例を解析した。アフェレーシス時年齢中央値は13歳(1～25),男性47例(58.0%),前治療数の中央値4(1～9),同種移植歴とinotuzumab ozogamicin,blinatumomabの使用歴は,それぞれ51例(63.0%),26例(32.1%),37例(45.7%)に認めた。アフェレーシス時末梢血芽球比率,CD3陽性細胞数は中央値0%(0～91.5),611/μl(35～4,210)で,出荷されたCD3陽性細胞数は中央値2.2×109個(0.5～8.3)であった。濃厚な前治療歴のある症例が含まれたが,製造失敗は見られなかった。引き続き製造失敗の状況を注視する必要がある。(著者抄録)

Responsible for pages：２．疾患別予防的ケア　２）血液疾患，造血幹細胞移植   Language：Japanese   Book type：Scholarly book

Responsible for pages：Ⅱ-4 血球除去，採取法　Ⅱ―4―2 末梢血幹細胞採取　149-156   Language：Japanese   Book type：Scholarly book

Responsible for pages：1．予防的ケア　２）血液疾患、造血幹細胞移植　22-29   Language：Japanese   Book type：Scholarly book

Event date： 2022.10

Language：Japanese  

Country：Japan  

Event date： 2021.12

Language：Japanese  

Country：Japan  

Event date： 2019.12

Language：Japanese  

Country：Japan  

Event date： 2018.12

Language：Japanese  

Country：Japan  

Event date： 2018.5

Language：Japanese  

Country：Japan  

Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Type：Competition, symposium, etc. 

Type：Competition, symposium, etc. 

卒後1,2年目の新規採用医師に対する講義と実習

ベッドサイドにおける輸血部門の見学・実習

卒後1,2年目の新規採用医師に対する講義と実習

卒後1年目の新規採用医師に対する講義と実習

卒後1年目の新規採用医師に対する講義と実習

Audience：General,　Scientific,　Company,　Civic organization,　Governmental agency

Type：Seminar, workshop

福岡県合同輸血療法委員会 世話人
中小医療施設における輸血医療の実態把握と支援に向けたタスクフォース委員

Audience：General,　Scientific,　Company,　Civic organization,　Governmental agency

Type：Seminar, workshop

福岡県合同輸血療法委員会 世話人
中小医療施設における輸血医療の実態把握と支援に向けたタスクフォース委員

Audience：General,　Scientific,　Company,　Civic organization,　Governmental agency

Type：Seminar, workshop