Background/Objectives: Recent studies have investigated the effectiveness of second-line agents in patients with ulcerative colitis (UC) who have experienced failure with first-line biologics. Although cytapheresis (CAP) is an effective therapeutic strategy for refractory UC, the efficacy of second-line agents in patients with UC with previous CAP failure remains unexplored. Herein, we examined the efficacy of biologics in patients with refractory UC who experienced non-response or insufficient response to previous CAP. Methods: We retrospectively assessed the efficacy of biologics administered between January 2013 and June 2024 in patients with refractory UC who experienced non-response or insufficient response to previous CAP. Rates of clinical remission, steroid-free remission, and endoscopic improvement were also determined. Clinical remission was evaluated using Lichtiger’s clinical activity index. Results: Eighty-one patients with refractory UC underwent CAP, thirty of whom were eligible for study inclusion. The use of biologics was associated with clinical and steroid-free remission rates of 75.9% and 44.8%, respectively. Clinical and steroid-free remission rates of biologics did not differ significantly between patients with an insufficient response to previous CAP and those with non-response to previous CAP. There were no significant differences in clinical or steroid-free remission rates of biologics between patients with steroid-dependent and steroid-refractory UC. Endoscopic improvement was observed in 54.5% of patients. Conclusions: Despite the limited number of patients, biologic therapy was effective in patients with refractory UC who had experienced a non-response or insufficient response to previous CAP. Accordingly, biologics may be a useful second-line therapy for patients with refractory UC who have failed CAP.

Analysis of Early Apheresis Immunophenotype, Batch Data Variables and Clinical Outcomes for Optimization of CAR-T-Cell Therapy in Aggressive B-Cell Lymphomas

Prognostic Impact of Clinical Factors and Cell Composition of Apheresis Samples on BCMA CAR-T Cell Therapy for Relapsed or Refractory Multiple Myeloma

Platelet concentrates (PCs) could be prepared using either whole-blood processes or apheresis instruments. During collection, processing and storage, some biochemical and functional changes occur, which may result in quality reduction. Quality evaluation of PCs may be helpful for the precise control of platelet (PLT) inventory to reduce the risk of refractoriness and adverse effects caused by platelet transfusion. The study was aimed to evaluate the quality of PCs which were produced by five processes: apheresis (AP) procedures (using three different cell separators: Amicus, Trima Accel and MCS+ instruments), platelet rich plasma (PRP), and buffy coat (BC). A total of 100 PCs (20 of each group) were assessed in respect of routine quality control, morphology, size distribution, destroyed and activated platelets, and production of platelet-derived microparticles (PMPs). All PCs have satisfied the recommended quality of volume, platelet count, residual WBC count, residual RBC count, pH, and sterility according to the Chinese Technical Manual. There was no difference among the 5 groups in morphology and size of PLT and PMPs. Dynamic light scattering test showed that apheresis PCs showed peaks around 10-20 nm, but not whole blood-derived PCs. PCs prepared by Amicus had the relatively high percentage of destroyed platelet, activated platelets and PMPs than other groups. The data suggested high heterogeneity of PMPs, destroyed and activated platelets in PCs produced by different processes, which might be helpful to manage the platelet inventory for targeted use.

Varnimcabtagene Autoleucel (IMN-003A): Differences in T Cell Subset Phenotype in B-ALL and B-NHL Cohorts Did Not Influence Efficacy Outcomes in the Phase-2 Study (IMAGINE)

For the optimal management of refractory ulcerative colitis (UC), secondary loss of response (LOR) and primary non-response to biologics is a critical issue. This article aimed to summarize the current literature on the use of cytapheresis (CAP) in patients with UC showing a poor response or LOR to biologics and discuss its advantages and limitations. Further, we summarized the efficacy of CAP in patients with UC showing insufficient response to thiopurines or immunomodulators (IM). Eight studies evaluated the efficacy of CAP in patients with UC with inadequate responses to thiopurines or IM. There were no significant differences in the rate of remission and steroid-free remission between patients exposed or not exposed to thiopurines or IM. Three studies evaluated the efficacy of CAP in patients with UC showing an insufficient response to biologic therapies. Mean remission rates of biologics exposed or unexposed patients were 29.4 % and 44.2%, respectively. Fourteen studies evaluated the efficacy of CAP in combination with biologics in patients with inflammatory bowel disease showing a poor response or LOR to biologics. The rates of remission/response and steroid-free remission in patients with UC ranged 32%-69% (mean: 48.0%, median: 42.9%) and 9%-75% (mean: 40.7%, median: 38%), respectively. CAP had the same effectiveness for remission induction with or without prior failure on thiopurines or IM but showed little benefit in patients with UC refractory to biologics. Although heterogeneity existed in the efficacy of the combination therapy with CAP and biologics, these combination therapies induced clinical remission/response and steroid-free remission in more than 40% of patients with UC refractory to biologics on average. Given the excellent safety profile of CAP, this combination therapy can be an alternative therapeutic strategy for UC refractory to biologics. Extensive prospective studies are needed to understand the efficacy of combination therapy with CAP and biologics.

The current approach to manufacture cold-stored platelets (CSP) replicates that of room temperature-stored platelets (RSP). However, this production method is associated with aggregate formation in CSP, a major pitfall that leads to significant wastage. We hypothesized that isolating platelets from whole blood as platelet-rich plasma (PRP) and storing them at a lower concentration reduces aggregates and that conventional bedside transfusion filtration removes CSP aggregates. We collected platelets from healthy humans by apheresis (AP) and by phlebotomy, from which we generated platelet-rich plasma (PRP). We split each AP and PRP platelets into two equal aliquots, storing one at 22°C (RT-PRP and RT-AP) and the other at 4°C (4C-PRP and 4C-AP). We evaluated platelets on day 0 and day 7 of storage. After storage, we measured platelet counts, aggregates, and other key characteristics before and after filtration by a bedside filter. After storage, the 4C-AP platelet counts decreased significantly. 4C-PRP preserved glucose better and prevented a significant increase in lactate contrary to 4C-AP. Filtration led to significantly lower platelet counts in both 4C-PRP and 4C-AP but not in their RT counterparts. Post filtration, we observed 50% fewer aggregates only in 4C-AP, whereas 4C-PRP showed an unexpected but significant increase in aggregates. Testing confirmed activation during storage but filtration did not further activate platelets. We provide evidence that 4C-PRP is an alternative to 4C-AP and that bedside filters reduce aggregates from 4C-AP. Further studies are needed to evaluate the hemostatic potential of 4C-PRP and the management of aggregates.

Number Of Apheresis Days To Reach Target Stem Cell Dose May Be a Predictor Of Secondary Myelodysplastic Syndrome and Acute Myelogenous Leukemia

BACKGROUNDIt is a crucial issue for patients with refractory ulcerative colitis (UC), including steroid-dependent and steroid-refractory patients, to achieve and maintain steroid-free remission. However, clinical studies focused on the achievement of steroid-free remission in refractory UC patients are insufficient. Cytapheresis (CAP) is a non-pharmacological extracorporeal therapy that is effective for active UC with fewer adverse effects. This study comprised UC patients treated with CAP and suggested the efficacy of CAP for refractory UC patients.AIMTo clarify the efficacy of CAP in achieving steroid-free remission in refractory UC patients.METHODSWe retrospectively reviewed the collected data from 55 patients with refractory UC treated with CAP. We analyzed the following points: (1) Efficacy of the first course of CAP; (2) Efficacy of the second, third, and fourth courses of CAP in patients who experienced relapses during the observation period; (3) Efficacy of CAP in colonic mucosa; and (4) Long-term efficacy of CAP. Clinical efficacy was evaluated using Lichtiger’s clinical activity index or Sutherland index (disease activity index). Mucosal healing was evaluated using Mayo endoscopic subscore. The primary and secondary endpoints were the rate of achievement of steroid-free remission and the rate of sustained steroid-free remission, respectively. Statistical analysis was performed using the paired t-test and chi-squared test.RESULTSThe rates of clinical remission, steroid-free remission, and poor effectiveness after CAP were 69.1%, 45.5%, and 30.9%, respectively. There were no significant differences in rate of steroid-free remission between patients with steroid-dependent and steroid-refractory UC. The mean disease activity index and Lichtiger’s clinical activity index scores were significantly decreased after CAP (P < 0.0001). The rates of steroid-free remission after the second, third, and fourth courses of CAP in patients who achieved steroid-free remission after the first course of CAP were 83.3%, 83.3%, and 60%, respectively. Mucosal healing was observed in all patients who achieved steroid-free remission after the first course of CAP. The rates of sustained steroid-free remission were 68.0%, 60.0%, and 56.0% at 12, 24, and 36 mo after the CAP. Nine patients (36%) had maintained steroid-free remission throughout the observation period.CONCLUSIONOur results suggest that CAP effectively induces and maintains steroid-free remission in refractory UC and re-induces steroid-free remission in patients achieving steroid-free remission after the first course of CAP.

As a pooled donor blood product, cryoprecipitate (cryo) carries risks of pathogen transmission. Pathogen inactivation (PI) improves the safety of cryoprecipitate, but its effects on haemostatic properties remain unclear. This study investigated protein expression in samples of pathogen inactivated cryoprecipitate (PI-cryo) using non-targeted quantitative proteomics and in vitro haemostatic capacity of PI-cryo. Whole blood (WB)- and apheresis (APH)-derived plasma was subject to PI with INTERCEPT® Blood System (Cerus Corporation, Concord, CA, USA) and cryo was prepared from treated plasma. Protein levels in PI-cryo and paired controls were quantified using liquid chromatography-tandem mass spectrometry. Functional haemostatic properties of PI-cryo were assessed using a microparticle (MP) prothrombinase assay, thrombin generation assay, and an in vitro coagulopathy model subjected to thromboelastometry. Over 300 proteins were quantified across paired PI-cryo and controls. PI did not alter the expression of coagulation factors, but levels of platelet-derived proteins and platelet-derived MPs were markedly lower in the WB PI-cryo group. Compared to controls, WB (but not APH) cryo samples demonstrated significantly lower MP prothrombinase activity, prolonged clotting time, and lower clot firmness on thromboelastometry after PI. However, PI did not affect overall thrombin generation variables in either group. Data from this study suggest that PI via INTERCEPT® Blood System does not significantly impact the coagulation factor content or function of cryo but reduces the higher MP content in WB-derived cryo. PI-cryo products may confer benefits in reducing pathogen transmission without affecting haemostatic function, but further in vivo assessment is warranted.

Platelets have the highest bacterial contamination risk of all blood components, and septic transfusion reactions remain a problem. A good estimate of contamination rates could provide information about residual risk and inform optimal testing strategies. We performed a systematic review and meta-analysis of platelet contamination rates by primary culture. A literature search in December 2019 identified articles on platelet contamination rates using primary culture. We used meta-analysis to estimate the overall rate of contamination and meta-regression to identify heterogeneity. We studied the following sources of heterogeneity: collection method, sample volume, positivity criteria, and study date. Contamination rate estimates were obtained for apheresis (AP), platelet rich plasma (PRP), and buffy coat (BC) collection methods. The search identified 6102 studies, and 22 were included for meta-analysis. Among these 22 studies, there were 21 AP cohorts (4,072,022 components), 4 PRP cohorts (138,869 components), and 15 BC cohorts (1,474,679 components). The overall mean contamination rate per 1000 components was 0.51 (95% CI: 0.38-0.67) including AP (0.23, 95% CI: 0.18-0.28), PRP, (0.38, 95% CI: 0.15-0.70), and BC (1.12, 95% CI: 0.51-1.96). There was considerable variability within each collection method. Sample volume, positivity criteria, and publication year were significant sources of heterogeneity. The bacterial contamination rate of platelets by primary culture is 1 in 1961. AP and PRP components showed a lower contamination rate than BC components. There is clinically significant between-study variability for each method. Larger sample volumes increased sensitivity, and bacterial contamination rates have decreased over time.

Objective To investigate the causes of ineffective platelet transfusion in patients with hematologic malignancies during myelosuppression and the therapeutic effect of rituximab. Methods A total of 180 patients with different hematologic malignancies in the First People's Hospital of Changzhou from January 2017 to December 2018 were selected. And the incidence of ineffective platelet transfusion during myelosuppression was observed. The changes of T and B lymphocyte subgroups and platelet counts before and after rituximab therapy in acute leukemia patients with platelet antibody-positive were compared, and the incidence of ineffective platelet transfusion with different platelet suspensions was analyzed. Results The ineffective platelet transfusion was observed in 45 of 180 patients (25.0%) during myelosuppression, including 30 (27.8%) of 108 patients with acute leukemia, 10 (23.3%) of 43 patients with myelodysplastic syndrome, 2 (13.3%) of 15 patients with malignant lymphoma, and 3 (21.4%) of 14 patients with multiple myeloma. The incidence of ineffective platelet transfusion in patients transfused with irradiated leukocyte depleted apheresis platelets (17.0%, 16/94) was lower than that in those with apheresis platelets (33.7%, 29/86), and the difference was statistically significant (χ2 = 6.68, P = 0.01). In 8 acute leukemia patients with platelet antibody-positive and the ineffective platelet transfusion after rituximab therapy, the increase of platelet count was observed in 5 patients. The differences of levels of CD19, CD20, CD4 and platelet count before and after treatment with rituximab were statistically significant (all P < 0.05). Conclusions The incidence of ineffective platelet transfusion is the highest in acute leukemia patients. Transfusion of human leukocyte antigen-matched platelets can improve the effect of platelet transfusion. Rituximab is effective in the ineffective platelets transfusion caused by immune factors. The incidence of ineffective platelet transfusion in irradiated leukocyte depleted apheresis platelets is lower compared with that in apheresis platelets. Key words: Hematologic neoplasms; Myelosuppression; Platelet transfusion; Medical futility

To explore the effect of storage time on discharge and content of exosome from leukocyte-reduced apheresis platelets (LRA-Plt). Exosome (EXO) from LRA-Plt were acquired by ExoQuick, and its' morphology, immunological marker and particle size distribution were detected by transmission electron microscopy (TEM), Western blotting and dynamic light scattering (DLS), respectively. The changes in particle size distribution of EXO from LRA-Plt with different storage time were detected by DLS. The changes in content of protein and RNA of EXO from LRA-Plt with different storage time were detected by Nanodrop® ND-2000. EXO from LRA-Plt was acquired successfully, which was characterized by cup-like shape, CD63/TSG101 enriched and Calnexin negative, and the particle size of which ranged from 30 to 200 nm. At early stored stage (stored for 1 day and 2 days), particle size of EXO from LRA-Plt was small and ranges from 30 to 40 nm. Meanwhile, the contents of protein and RNA were low. The particle size distribution, contents of protein and RNA of EXO from LRA-Plt were not significanty different ammg groups (P＞0.05). At middle-late stored stage (stored for 3, 4 and 5 days), the particle size of EXO from LRA-Plt was larger than that of early stored stage, which ranges was from 130 to 200 nm. Meanwhile, the contents of protein and RNA were higher than those of early stored stage. Particle size distribution, contents of protein and RNA of EXO from LRA-Plt stored for middle-late stage were significant higher than those of early stored stage (P＜0.05). Morphology of EXO from LRA-Plt stored for middle-late stage was different from that stored for early stored stage. Moreover, the particle size distribution, contents of protein and RNA of EXO from LRA-Plt stored for middle-late stage were higher than those of early stored stage. A large amount of protein and RNA contained in EXO from LRA-Plt may participate in the multiple functions caused by platelet transfusion.

Objective To explore the scrapping reasons for the apheresis platele consumables of 3 different types blood cell separators used in Chengdu Blood Center. Methods From January 2015 to December 2017, a total of 63 782 sets of apheresis platelets consumables used in Chengdu Blood Center and Tianfu Blood Donation House were selected as subjects. Among them, the apheresis platelets consumables of MCS+ , Amicus, Trima Accel blood cell separators were 28 351, 15 482 and 19 949 sets, respectively. Retrospective investigation method was adopted to inquire the material scrapping situation in the resource management of Chengdu Blood Center and Tianfu Blood Donation House, through the Qiao Blood Station Management System. And the scrapping amount and reasons of apheresis platele consumables were counted, and were checked with the scrapping records from Consumables Scrap Statistics in Apheresis Room. Reasons for scrapped of apheresis platele consumables include consumable factors (pipe wrinkles, breakage, leakage, etc.) and collection factors (venipuncture failure, machine fault, chylemia blood, red blood cell overflow, blood donation response, etc.). After the data were verified correctly, the scrapping rates of apheresis platelets consumables were calculated. The scrapping rates of different blood cell separators and different scrapping reasons were compared by chi-square test, respectively. Results ① Among the 63 782 sets of apheresis platelets consumables, a total of 900 sets were scrapped, with a scrapping rate of 1.41% (900/63 782). The scrapping rate of MCS+ blood cell separators was 1.83% (518/28 351), which was higher than that of 1.41% (219/15 482) of Amicus and 0.82% (163/19 949) of Trima Accel blood cell separators, and the differences were statistically significant (χ2=239.10, P<0.001; χ2=162.15, P<0.001). ② Among the 900 sets of scrapping apheresis platelets consumables of this study, the scrapping rate due to collection factors was 1.16% (738/63 782), which was higher than that of 0.25% (162/63 782) due to consumables factors, and the difference was statistically significant (χ2=304.28, P<0.001). Among the 738 sets of scrapping apheresis platelets consumables due to collection factors, the scrapping rate of MCS+ blood cell separators was 1.61% (456/28 351), which was higher than that of 0.96% (148/15 482) of Amicus and 0.67% (134/19 949) of Trima Accel blood cell separators, and the differences were statistically significant (χ2=220.79, P<0.001; χ2=164.42, P<0.001). Among the 162 sets of scrapping apheresis platelets consumables due to consumables factors, the scrapping rate of Amicus blood cell separators was 0.46% (71/15 482), which was higher than of 0.22% (62/28 351) of MCS+ and 0.15% (29/19 949) of Trima Accel blood cell separators, and the differences were statistically significant (χ2=19.05, P<0.001; χ2=30.38, P<0.001). ③ Among the 738 sets of scrapping apheresis platelets consumables due to collection factors, venipuncture failure (0.38%, 241/63 782), machine fault (0.23%, 144/63 782) and chyle blood (0.21%, 133/63 782) were main scrapping reasons. Conclusions There are differences in the scrapping rate and reasons of apheresis platele consumables scrapping of 3 types of blood cell separators used in Chengdu Blood Center. The reasons for scrapping are mainly the collection factors, including venipuncture failure, machine failure and chyle blood. In the work of apheresis platelets collection, the appropriate blood cell separators and matching apheresis platelets consumables, should be selected according to the physical conditions of the blood donors, as well as the characteristics of the blood cell separators. Key words: Blood platelets; Blood safety; Apheresis platelets; Blood cell separators; Blood scrap

Objective To analyze the causes of unqualification in primary blood screening among voluntary blood donors of apheresis platelets in Chengdu Blood Center. Methods A total of 36 127 cases of voluntary blood donors who participated in apheresis platelets donation in Chengdu Blood Center from January to December 2017 were selected as study objects. Age of blood donors was (32.4±7.7) years. Male and female blood donors were 26 423 and 9 704 cases, respectively. Before donation of apheresis platelets, about 4 mL of whole blood was taken from the elbow vein of each blood donor, and these whole blood samples were used for the inspection of primary blood screening. Inspection items of primary blood screening included alanine transaminase (ALT) value, platelet count, hematocrit (HCT), white blood cell count (WBC), hemoglobin (Hb) value, chylemia and hepatitis B virus surface antigen (HBsAg) expression. Then, qualification situations for primary blood screening of apheresis platelets donors were assessed according to Technical Operation Procedure for Blood Stations (2015 Edition). Total unqualified rate of primary blood screening in all apheresis platelets donors, and unqualified rates of each inspection item were counted, respectively. Chi-square test was used to compare the unqualified rates of each inspection item of all blood donors, as well as the unqualified rates between the male and female blood donors. The procedures followed in this study were in line with the requirements of the revised Declaration of Helsinki of World Medical Association in 2013. And all blood donors signed Informed Consent of Blood Donors before blood donating. Results ① In this study, among the 36 127 blood donors who participated in apheresis platelets donation in Chengdu Blood Center in 2017, 19 323 cases were unqualified in primary blood screening, and the total unqualified rate of primary blood screening was 53.49%. ② Among the 19 323 cases of apheresis platelets donors who were unqualified in primary blood screening, the unqualified rates of the primary blood screening items from high to low were 15.82% in unqualification of HCT, 15.45% in unqualification of platelet count, 9.72% in unqualification of ALT value, 7.60% in unqualification of WBC, 3.96% in unqualification of chylemia, 0.80% in unqualification of Hb value, and 0.17% in unqualification of HBsAg. Overall comparison of the unqualified rates of each inspection item of primary blood screening, the difference was statistically significant (χ2=12 724.350, P<0.001). The main causes of unqualification in primary blood screening among apheresis platelets donors were decrease of HCT, increase of ALT value, and decrease of platelet count. The proportion of unqualified blood donors with these three causes accounted for 76.63%(14 806/19 323) of the total unqualified blood donors. ③ Among the 19 323 cases of apheresis platelets donors who were unqualified in primary blood screening, the unqualified rate of male blood donors was 40.44% (10 689/26 423), which was lower than 89.01% (8 638/9 704) of female blood donors, and the difference was statistically significant (χ2=6 731.805, P<0.001). Of which, the unqualified rates of ALT value (10.63%) and platelet count (15.96%) of male blood donors were higher than those of 7.23% and 14.04% in female donors, respectively; the unqualified rates of HCT (2.97%), Hb value (0.12%), WBC (7.14%) and chylemia (3.44%) of male blood donors were lower than those of 50.80%, 2.61%, 8.83% and 5.37% in female blood donors, respectively; and all the differences in above inspection items of primary blood screening between male and female blood donors had statistical significance (χ2=77.930, 20.199, 12 194.302, 564.119, 28.879, 81.479; P<0.001). Conclusions The main causes of unqualification in primary blood screening among apheresis platelets donors in Chengdu include decrease of HCT, increase of ALT value, and decrease of platelet count. Unqualification of male blood donors are mainly due to increase of ALT value and decrease of platelet count. The majority unqualification of female blood donors is decrease of HCT. Therefore, according to the causes of unqualification in primary blood screening among different apheresis platelets donation populations, the corresponding intervention recruitment strategy should be taken to improve the qualification rate in primary blood screening among apheresis platelets donors. Key words: Voluntary blood donor; Apheresis platelets; Alanine transaminase; Plantlet count; Hematocrit; Primary blood screening, unqualification; Causes analysis; Recruitment strategy, voluntary blood donors

Treatment of acute exacerbations of neuromyelitis optica (NMO) typically consists of intravenous methylprednisolone, apheresis therapy (plasmapheresis

Objective To explore the application of marketing strategies and methods in recruitment of voluntary apheresis platelet donors. Methods From November 2016 to October 2017, a total of 2 762 voluntary blood donors, who had donated apheresis platelet at the Foshan Central Blood Station, were included in study group. During that period, the marketing strategies and methods already applied to recruitment of voluntary apheresis platelet donors. And from November 2015 to October 2016, a total of 2 621 voluntary blood donors, who had donated apheresis platelet at the same blood station, were included in control group. During that period, the marketing strategies and methods were not applied to recruitment of voluntary apheresis platelet donors yet. Marketing strategies and methods for the recruitment of voluntary apheresis platelet donors included: mobilization of apheresis platelet donation population, optimization of blood donation environment, improvement of blood donation service mode, improvement of blood collection techniques and service levels of blood collection staff, adjustment of blood donation souvenirs, improvement of post-donation services, etc.. A retrospective analysis method was used to investigate the incidences of adverse reactions of voluntary apheresis platelet donors, the proportions of voluntary blood donors who repeatedly donated apheresis platelet more than twice in one year, and proportions of voluntary blood donors who donated 20 U of apheresis platelet at a single blood donation in the two groups, respectively. By the way of questionnaire, the satisfactions of blood donation of voluntary apheresis platelet donors in the two groups were investigated. By chi-square test and correction for continuity chi-square test, the incidences of adverse reactions of voluntary apheresis platelet donors, the proportions of voluntary blood donors who repeatedly donated apheresis platelet, the proportions of voluntary blood donors who donated 20 U of apheresis in a single blood donation, and satisfactions of blood donation of voluntary apheresis platelet donors between study and control group were compared, respectively. Results ① In this study, the incidence of adverse reactions of voluntary apheresis platelet donors in the study group was 0.4% (11/2 762), which was lower than 0.9% (24/2 621) in the control group, and the difference was statistically significant (χ2=5.574, P=0.018). ② The proportion of voluntary blood donors who repeatedly donated apheresis platelet in the study group was 16.6% (458/2 762), which was higher than 12.0% (314/2 621) in the control group, and the difference was statistically significant (χ2=17.074, P<0.001). Among the voluntary blood donors in the control group, the proportion of donors who donated twice and three times or more was 5.6% and 11.0%, respectively, which were higher than 2.8% and 9.2% in the control groups, with statistically differences (χ2=25.116, 4.863; P<0.001, =0.027). To compare the composition ratios of voluntary apheresis platelet donors who donated twice and three times or more in the two groups, there was statistically significant difference (χ2=9.055, P=0.003). ③ The proportion of blood donors who donated 20 U apheresis platelet was 21.1% (584/2 762) in study group, which was higher than 8.0% (210/262 1) in control group, and the difference was statistically significant (χ2=184.43, P<0.001). ④ The total satisfaction of blood donation of voluntary apheresis platelet donors in study group was 95.0% (114/120), was higher than 85.0% (102/120) in control group , and the difference was statistically significant (χ2=6.667, P=0.010). The composition ratio of the different degree of satisfactions of voluntary apheresis platelet donors between the two groups were compared, and there was statistically significant difference (χ2=8.682, P=0.034). Conclusions The marketing strategies and methods were applied in the recruitment of voluntary apheresis platelet donors, which could reduce the incidence and severity of adverse reactions of apheresis platelet donation, and increase number of voluntary apheresis platelet donors and satisfaction of apheresis platelet donation. So, the blood collection and supply institutions can not only develop the potential apheresis platelet donors, but also increase the number of apheresis platelet donors who could donate twice or more, which ensures continuous and healthy development of apheresis platelets donation, as well as adequate supply of apheresis platelets in clinical. Key words: Blood donors; Marketing; Blood platelets; Blood donation team; Recruiting

Objective To investigate the application of apheresis autologous red blood cell transfusion technology in total hip arthroplasty (THA). Methods From February to July 2016, a total of 191 patients who received THA treatment in the Chinese PLA General Hospital were selected as the research subjects. All patients were randomly divided into study group (n=91) and control group (n=100) by simple random sampling method. Patients in the study group received autologous red blood cell apheresis before THA, while the control group did not collect any autologous blood before THA. The main blood indicators, including red blood cell count, levels of hemoglobin (Hb), white blood cell count, platelet count, were recorded before apheresis in study group or before THA in control group, as well as on the 1st and 3rd day after THA in the 2 groups, respectively. The amount of blood loss during THA, allogeneic transfusion volume on the day of THA, allogeneic blood transfusion rate, allogeneic red blood cell transfusion volume, allogeneic red blood cell transfusion rate, allogeneic plasma transfusion volume, and allogeneic plasma transfusion rate were also observed. Mann-Whitney U test, Wilcoxon signed rank test or χ2 test were used to compare the difference of the above indications between the patients of 2 groups. The procedure of this study is in accordance with the requirements of the revised World Medical Association Declaration of Helsinki in 2013. Informed consent was obtained from each patient. Results ① In this study, there were no statistically significant differences in median red blood cell count of patients between study group before apheresis and that of control group before THA, as well as those of patients between the 2 groups on the 1st and 3rd day after THA (P>0.05). In study group, the median red blood cell count of patients before apheresis was higher than that of patients on the 1st and 3rd day after THA, and the differences were statistically significant (4.5×1012/L vs 4.1×1012/L, Z=-4.043, P 0.05). On the 1st day after THA, the median Hb level of patients in study group was 125 g/L (113-134 g/L), which was higher than 115 g/L (107-135 g/L) of patients in control group, and the difference was statistically significant (Z=-2.302, P=0.021). In study group, the median Hb level of patients before apheresis was higher than those of patients on the 1st and 3rd day after THA, and the differences were statistically significant (137 g/L vs 125 g/L, Z=-6.668, P 0.05). On the 1st day after THA, the median white blood cell count of patients in study group was 11.34×109/L (9.75×109/L-12.76×109/L), which was higher than 10.20×109/L (8.50×109/L-12.39×109/L) in control group, and the difference was statistically significant (Z=-2.399, P=0.016). In study group, the median white blood cell count of patients on the 1st day after THA was higher than those of patients before THA and on the 3rd day after THA, and the differences were statistically significant (11.34×109/L vs 6.15×109/L, Z=-8.272, P 0.05). In study group, the median platelet count of patients before apheresis was higher than those of patients on the 1st and 3rd day after THA, and the differences were statistically significant (229×109/L vs 183×109/L, Z=-7.796, P 0.05). The median volume of allogeneic blood transfusion of patients in study group was 2.6 U (1.0-4.4 U), which was lower than 5.3 U (3.0-7.2 U) of patients in control group, and the difference was statistically significant (Z=-3.903, P 0.05). The rate of allogenic red blood cell transfusion of patients in study group was 52.7%, which was lower than 82.0% of patients in control group, with a statistically significant difference (χ2=18.756, P<0.001). Conclusions The apheresis autologous red blood cell transfusion could meet the needs of clinical blood transfusion in patients with THA, which is safe and effective, and could be promoted during surgery. Key words: Blood transfusion, autologous; Arthroplasty, replacement, hip; Blood component transfusion; Apheresis autologous red blood cell; Autologous blood

Objective To investigate the efficacy and safety of granulocyte and monocyte adsorptive apheresis (GMA) in the treatment of ulcerative colitis (UC) patients. Methods A retrospective study was conducted to analyze the clinical data of GMA treatment on 13 patients diagnosed with UC at Shanghai First People′s Hospital from January 2015 to June 2017. The clinical activity index (CAI) , endoscopic activity index (EAI) and laboratory parameters of patients before and after 5-week therapy were compared, and the adverse effects during the treatment of GMA were observed. Results Compared with those before GMA treatment, both CAI (4.89 ± 1.72 vs. 1.21 ± 2.15, P= 0.00) and EAI (7.23 ± 2.27 vs. 3.19 ± 1.99, P= 0.00) were decreased significantly (P 0.05) . During the treatment course, no severe adverse effects were observed and the treatment was well tolerated. Conclusion GMA is safe and effective in the treatment of UC patients. Key words: Granulocyte and monocyte adsorptive apheresis; Inflammatory bowel disease; Ulcerative colitis; Efficacy; Safety

Expected outcome of patients with acute renal failure and severe sepsis and multi organ dysfunction with focus on apheresis