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Gamma-irradiation of blood products following autologous stem cell transplantation: surveillance of the policy of 35 centers

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Abstract

Blood products should be irradiated during allogeneic stem cell transplantation and before performing autologous stem cell harvest for prevention of acute transfusion-associated graft-versus-host disease (TA-GVHD). Usually, irradiation of all blood products is continued lifelong in the allogeneic setting. Up to now, no broadly accepted rules exist concerning autologous stem cell transplantation. We present here the results of an inquiry sent to 47 German transplantation centers regarding the transfusion policy following autologous stem cell transplantation. The results of 35 answering centers are included. Ten out of 35 centers offer irradiated blood products lifelong to their patients, mainly for the prevention of mistransfusion of non-irradiated blood components to allogeneic recipients. Twenty-two out of 35 centers administer irradiated blood products for a special time span after autologous stem cell transplantation. In most centers, this time span is from 3 to 6 months. Only few centers (4/35) expand this time span to 1–2 years after transplantation. A minority of centers (3/35) gave non-irradiated blood products to all of their patients or to patients not suffering from acute leukemia or after total body irradiation (TBI) containing preparative regimens. Most centers (19/35) deliver irradiated blood products irrespective of the conditioning regimen. Fifty-three percent of the centers decide to donate irradiated blood products not depending on immunological reconstitution. But in most centers some kind of hematological reconstitution is a major criterion for termination of irradiated blood products. Sixty-four percent of the centers made no difference in transfusion policy in regard to the underlying disease. No center experienced cases of proofed TA-GVHD. Guidelines should be worked out concerning transfusion policy after autologous stem cell transplantation.

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Author information

Authors and Affiliations

  1. Medizinische Klinik A, Klinikum Ludwigshafen GmbH, Bremserstraße 79, 67063, Ludwigshafen/Rhein, Germany

    B. Weiss, M. Hoffmann & M. Uppenkamp

  2. Institut für Haemostaseologie und Transfusionsmedizin, Klinikum der Stadt, Ludwigshafen gGmbH, Bremserstraße 79, 67063, Ludwigshafen/Rhein, Germany

    C. Anders & P. Hellstern

  3. Hämatologische Abteilung, Allgemeines Krankenhaus St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany

    N. Schmitz

Authors
  1. B. Weiss
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  2. M. Hoffmann
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  3. C. Anders
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  4. P. Hellstern
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  5. N. Schmitz
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  6. M. Uppenkamp
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Corresponding author

Correspondence to B. Weiss.

Additional information

On behalf of the Deutsche Arbeitsgemeinschaft für Knochenmark- und Blutstammzelltransplantation (DAG-KBT)

List of participating centers

- Zentralklinikum Augsburg, II. Medizinische Klinik, Hämatologie und Onkologie

- Humaine Klinikum Bad Saarow, Ost-Brandenburgisches Tumorzentrum

- Campus Virchow-Klinikum Berlin, Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Knochenmarktransplantation

- Freie Universität Berlin, Universitätsklinikum Benjamin Franklin, Medizinische Klinik III

- Campus Charité Mitte Berlin, Medizinische Klinik II mit Schwerpunkt Onkologie und Hämatologie

- Rheinische Friedrich-Wilhelms-Universität Bonn, Medizinische Klinik und Poliklinik I, Schwerpunkt Hämatologie und Internistische Onkologie

- Universitätsklinik Dresden, Medizinische Klinik I, Schwerpunkt Hämatologie und Onkologie

- Universitätsklinikum Düsseldorf, Medizinische Klinik A, Schwerpunkt Hämatologie, Onkologie und Klinische Immunologie

- Universität Erlangen-Nürnberg, Medizinische Klinik III, Abteilung für Hämatologie und Onkologie

- Universitätsklinikum Essen, Medizinische Klinik und Poliklinik, Abteilung für Hämatologie

- Universitätsklinikum Essen, Innere Klinik und Poliklinik, Westdeutsches Tumorzentrum

- Kliniken Essen Süd, Ev. Krankenhaus Essen-Werden, Abteilung Hämatologie

- Medizinische Universitätsklinik Freiburg, Abteilung Innere Medizin, Hämatologie und Onkologie

- Katholisches Krankenhaus Hagen, Klinik für Hämatologie und Onkologie

- Universitätsklinikum Hamburg-Eppendorf, Abteilung Hämatologie und Onkologie, Einrichtung für Knochenmarktransplantation

- Medizinische Hochschule Hannover, Abteilung Hämatologie und Onkologie, Zentrum Innere Medizin

- Ruprecht-Karls-Universität Heidelberg, Medizinische Universitätsklinik, Abteilung Hämatologie/Onkologie und Rheumatologie

- Klinik für Knochenmarktransplantation und Hämatologie/Onkologie, Idar-Oberstein

- Christian-Albrechts-Universität Kiel, II. Medizinische Klinik und Poliklinik

- Westpfalz Klinikum Kaiserslautern, Medizinische Klinik I

- Städtisches Klinikum Karlsruhe, II. Medizinische Klinik, Hämatologie/Onkologie/Infektionskrankheiten

- Klinikum Ludwigshafen, Medizinische Klinik A, Schwerpunkt Hämatologie und Onkologie

- Klinikum der Johannes Gutenberg-Universität Mainz, III Medizinische Klinik/KMT-Ambulanz

- Universitätsklinikum Mannheim, III Medizinische Klinikum Ludwigshafen GmbH

- Klinikum der Philipps-Universität Marburg, Klinik für Hämatologie, Onkologie und Immunologie

- Klinikum rechts der Isar der Technischen Universität München, III. Medizinische Klinik

- Klinikum Nürnberg, Medizinische Klinik 5, Institut für Medizinische Onkologie und Hämatologie, Einheit für Knochenmarktransplantation

- Universitätsklinikum Regensburg, Abteilung für Hämatologie und Internistische Onkologie

- Universität Rostock, Medizinische Fakultät, Abteilung Hämatologie und Onkologie

- Diakonissenkrankenhaus Stuttgart, Medizinische Klink II

- Katharinenhospital Stuttgart, Zentrum Innere Medizin, Abteilung Onkologie

- Robert-Bosch-Krankenhaus Stuttgart, Innere Medizin II, Abteilung Hämatologie, Onkologie und Klinische Immunologie

- Eberhard-Karls-Universität Tübingen, Medizinische Klinik II, Abteilung Hämatologie, Onkologie, Rheumatologie und Immunologie

- Deutsche Klinik für Diagnostik Wiesbaden, KMT-Zentrum

- Universität Würzburg, Medizinische Poliklinik, Hämatologie/Onkologie

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Weiss, B., Hoffmann, M., Anders, C. et al. Gamma-irradiation of blood products following autologous stem cell transplantation: surveillance of the policy of 35 centers. Ann Hematol 83, 44–49 (2004). https://doi.org/10.1007/s00277-003-0785-z

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  • DOI: https://doi.org/10.1007/s00277-003-0785-z

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