Edward L. Murphy

University of California, San Francisco

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Michael P. Busch

Vitalant

Brian Custer

Vitalant

David J. Wright

Westat (United States)

Roberta Bruhn

Pacific Research Institute

Steven Kleinman

University of British Columbia

Zhanna Kaidarova

Vitalant

Nareg H. Roubinian

University of San Francisco

Simone A. Glynn

National Heart Lung and Blood Institute

George B. Schreiber

Maryland Oncology Hematology

Claude Tayou Tagny

University Teaching Hospital of Yaounde

Cooperative Institutions

University of California, San Francisco

229

Blood Systems Research Institute

159

National Institutes of Health

American Red Cross

Westat (United States)

Johns Hopkins University

National Cancer Institute

Universidade de São Paulo

Centers for Disease Control and Prevention

Institut National de la Transfusion Sanguine

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Somatic STAT3 Mutations in CD8+ T Cells of HTLV-2 Positive Blood Donors

Blood (2021)

Daehong Kim Mikko Myllymäki Matti Kankainen Timo Järvinen Giljun Park

10.1182/blood-2021-146326

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A multicenter study of plasma use in the United States

Transfusion (2014)

Darrell J. Triulzi Jerome L. Gottschall Edward L. Murphy Yanyun Wu Paul M. Ness

Detailed information regarding plasma use in the United States is needed to identify opportunities for practice improvement and design of clinical trials of plasma therapy.Ten US hospitals collected detailed medical information from the electronic health records for 1 year (2010-2011) for all adult patients transfused with plasma.A total of 72,167 units of plasma were transfused in 19,596 doses to 9269 patients. The median dose of plasma was 2 units (interquartile range, 2-4; range 1-72); 15% of doses were 1 unit, and 45% were 2 units. When adjusted by patient body weight (kg), the median dose was 7.3 mL/kg (interquartile range, 5.5-12.0). The median pretransfusion international normalized ratio (INR) was 1.9 (25%-75% interquartile range, 1.6-2.6). A total of 22.5% of plasma transfusions were given to patients with an INR of less than 1.6 and 48.5% for an INR of 2.0 or more. The median posttransfusion INR was 1.6 (interquartile range, 1.4-2.0). Only 42% of plasma transfusions resulted in a posttransfusion INR of less than 1.6. Correction of INR increased as the plasma dose increased from 1 to 4 units (p < 0.001). There was no difference in the INR response to different types of plasma. The most common issue locations were general ward (38%) and intensive care unit (ICU; 42%).This large database describing plasma utilization in the United States provides evidence for both inadequate dosing and unnecessary transfusion. Measures to improve plasma transfusion practice and clinical trials should be directed at patients on medical and surgical wards and in the ICU where plasma is most commonly used.

10.1111/trf.12970

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Citations (54)

The effect of previous pregnancy and transfusion on HLA alloimmunization in blood donors: implications for a transfusion‐related acute lung injury risk reduction strategy

Transfusion (2009)

Darrell J. Triulzi Steven Kleinman Ram Kakaiya Michael P. Busch Philip J. Norris

BACKGROUND: Antibodies to human leukocyte antigens (HLA) in donated blood have been implicated as a cause of transfusion-related acute lung injury (TRALI). A potential measure to reduce the risk of TRALI includes screening plateletpheresis donors for HLA antibodies. The prevalence of HLA antibodies and their relationship to previous transfusion or pregnancy in blood donors was determined. STUDY DESIGN AND METHODS: A total of 8171 volunteer blood donors were prospectively recruited by six US blood centers from December 2006 to May 2007. Donors provided a detailed history of pregnancy and transfusion and a sample for HLA Class I and II antibody testing by multiantigen bead flow analysis. RESULTS: A total of 8171 donors were enrolled; 7920 (96.9%) had valid HLA antibody test results and 7841 (99%) of those had complete pregnancy and transfusion information. The prevalence of any HLA antibody was similar in nontransfused (n = 1138) and transfused (n = 895) men, 1.0% versus 1.7% (p = 0.16). HLA antibodies were detected in 17.3% of all female donors (n = 5834) and in 24.4% of those with a history of previous pregnancy (n = 3992). The prevalence of HLA antibodies increased in women with greater numbers of pregnancy: 1.7% (zero), 11.2% (one), 22.5% (two), 27.5% (three), and 32.2% (four or more pregnancies; p < 0.0001). CONCLUSION: HLA Class I and Class II antibodies are detectable at low prevalence in male donors regardless of transfusion and in female donors without known immunizing events. The prevalence of HLA antibodies increases significantly with more pregnancies. These data will allow blood centers to estimate the impact of HLA antibody testing as a potential TRALI risk reduction measure.

Isoantibodies

10.1111/j.1537-2995.2009.02206.x

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Citations (317)

HTLV-I-associated leukemia: A model for chronic retroviral diseases

Annals of Neurology (1988)

Edward L. Murphy William A. Blattner

Human T-lymphotropic virus type I (HTLV-I) has been associated with adult T-cell leukemia/lymphoma (ATL), a malignancy of mature CD4-positive lymphocytes, and with tropical spastic paraparesis (TSP), a demyelinating neurological syndrome. This article describes the clinical and pathological features of ATL and reviews the epidemiology of this disease and of its putative etiological agent, HTLV-I. From what is known about the molecular biology and epidemiology of HTLV-I, hypotheses on the etiology of TSP are proposed, and strategies for studying the neurological syndrome are suggested.

Tropical spastic paraparesis

Etiology

Human T-lymphotropic virus

10.1002/ana.410230739

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Citations (44)

A novel high performing multiplex immunoassay Multi-HTLV for serological confirmation and typing of HTLV infections

PLoS neglected tropical diseases (2021)

Lola Marqué Peter Liehl Jasper de Boer Hans Pottel Edward L. Murphy

Human T-Cell Lymphotropic Viruses (HTLV) type 1 and type 2 account for an estimated 5 to 10 million infections worldwide and are transmitted through breast feeding, sexual contacts and contaminated cellular blood components. HTLV-associated syndromes are considered as neglected diseases for which there are no vaccines or therapies available, making it particularly important to ensure the best possible diagnosis to enable proper counselling of infected persons and avoid secondary transmission. Although high quality antibody screening assays are available, currently available confirmatory tests are costly and have variable performance, with high rates of indeterminate and non-typable results reported in many regions of the world. The objective of this project was to develop and validate a new high-performance multiplex immunoassay for confirmation and discrimination of HTLV-1 and HTLV-2 strains.The multiplex platform was used first as a tool to identify suitable antigens and in a second step for assay development. With data generated on over 400 HTLV-positive blood donors sourced from USA and French blood banks, we developed and validated a high-precision interpretation algorithm. The Multi-HTLV assay demonstrated very high performance for confirmation and strain discrimination with 100% sensitivity, 98.1% specificity and 100% of typing accuracy in validation samples. The assay can be interpreted either visually or automatically with a colorimetric image reader and custom algorithm, providing highly reliable results.The newly developed Multi-HTLV is very competitive with currently used confirmatory assays and reduces considerably the number of indeterminate results. The multiparametric nature of the assay opens new avenues to study specific serological signatures of each patient, follow the evolution of infection, and explore utility for HTLV disease prognosis. Improving HTLV diagnostic testing will be critical to reduce transmission and to improve monitoring of seropositive patients.

Multiplex

10.1371/journal.pntd.0009925

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Preexisting Infection with Human T-Cell Lymphotropic Virus Type 2 neither Exacerbates nor Attenuates Simian Immunodeficiency Virus SIV _mac251 Infection in Macaques

Journal of Virology (2010)

Shari N. Gordon Anna R. Weissman Valentina Cecchinato Claudio Fenizia Zhong-Min Ma

Coinfection with human T-cell lymphotropic virus type 2 (HTLV-2) and human immunodeficiency virus type 1 (HIV-1) has been reported to have either a slowed disease course or to have no effect on progression to AIDS. In this study, we generated a coinfection animal model and investigated whether HTLV-2 could persistently infect macaques, induce a T-cell response, and impact simian immunodeficiency virus SIV(mac251)-induced disease. We found that inoculation of irradiated HTLV-2-infected T cells into Indian rhesus macaques elicited humoral and T-cell responses to HTLV-2 antigens at both systemic and mucosal sites. Low levels of HTLV-2 provirus DNA were detected in the blood, lymphoid tissues, and gastrointestinal tracts of infected animals. Exposure of HTLV-2-infected or naïve macaques to SIV(mac251) demonstrated comparable levels of SIV(mac251) viral replication, similar rates of mucosal and peripheral CD4(+) T-cell loss, and increased T-cell proliferation. Additionally, neither the magnitude nor the functional capacity of the SIV-specific T-cell-mediated immune response was different in HTLV-2/SIV(mac251) coinfected animals versus SIV(mac251) singly infected controls. Thus, HTLV-2 targets mucosal sites, persists, and importantly does not exacerbate SIV(mac251) infection. These data provide the impetus for the development of an attenuated HTLV-2-based vectored vaccine for HIV-1; this approach could elicit persistent mucosal immunity that may prevent HIV-1/SIV(mac251) infection.

Simian immunodeficiency virus

Simian

10.1128/jvi.01655-09

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Citations (8)

Are different motivations and social capital score associated with return behaviour among Brazilian voluntary non‐remunerated blood donors?

Transfusion Medicine (2020)

Fernanda G. M. D. Estrada Cláudia Di Lorenzo Oliveira Éster Cerdeira Sabino Brian Custer Thelma T. Gonçalez

Summary Background We examined the association between social capital score, motivator factors and demographic and donation characteristics and donor return at three Brazilian blood centres in Recife, São Paulo and Belo Horizonte. Material and methods A total of 5974 donors were interviewed about motivation factors to donate and cognitive and structural social capital just before an effective donation in three Brazilians blood centres in 2009. We assessed the return to a new donation within 2 years for each of these donors. Demographic and donation characteristics, motivators and scores of social capital and their association with donors' return were assessed. Results Overall, 3123 (52.3%) of the study subjects returned for a blood donation at least once. Predictors of donors' return were male gender (adjusted odds ratio [AOR] = 1.6, 1.3‐1.9, for replacement and AOR = 1.3, 1.2‐1.6, for community donors), previous donation (AOR = 2.7, 2.3‐3.3, for replacement and AOR = 2.9, 2.5‐3.5, for community donors) and high altruism (AOR = 1.3, 1.1‐1.7, for replacement and AOR = 1.2, 1.0‐1.5, for community donors). Altruism was the only motivator associated with return behaviour. Donors from Recife and São Paulo were more likely to return for replacement and/or for community donations than donors from Belo Horizonte. There was no association between social capital score and donor return behaviour. Conclusion The likelihood to return for a subsequent blood donation is dependent upon characteristics of individual donors and also varies in different regions of Brazil. However, social capital was not associated with the likelihood of return behaviour. A better understanding of altruistic categories and appeals may help to improve donor recruitment and retention.

Altruism

Odds

Turnover

10.1111/tme.12684

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Citations (0)

Transfusion Medicine Reviews (1994)

Girish N. Vyas Gang Yang Edward L. Murphy

10.1016/s0887-7963(94)70117-6

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Citations (20)

Updated characteristics of blood services, donors and blood products in 11 French‐speaking African countries

Vox Sanguinis (2018)

Claude Tayou Tagny Syria Laperche Edward L. Murphy

Background and objectives The Francophone Africa Transfusion Research Network conducted the first large and comprehensive surveys on the status of blood safety in francophone African countries in 2009 and 2012. Since then, there has been substantial investment in blood safety but little is known about progress made in the region. Materials and Methods This multicentre cross‐sectional study describes characteristics of blood services, donors and blood products and compares results with previous data. A web‐based questionnaire collected data of 2016 from 38 blood facilities in 11 French‐speaking countries. Data were analysed according to type of blood services and compared to similar studies conducted in 2009 and 2012. Results The study included data on 572 933 donations from 366 844 donors. Compared to 2012, there was an increase in the median proportion of voluntary nonremunerated blood donation (+22%) ( P = 0·004), and a reduction from 2·1 to 0·9 ( P = 0·01), from 10·3 to 6·7 ( P = 0·00), from 3·2 to 1·3 ( P = 0·006) and from 1 to 0·4 ( P = 0·03) in median seroprevalences of HIV , HBV , HCV and syphilis, respectively. The median proportion of blood orders fulfilled decreased (−18·2%) ( P = 0·001). The number of technical staff per 1000 donations ranged from 1 to 54 with hospital‐based blood transfusion services having 12‐fold more staff than National and Regional services. Conclusion Several indicators have improved in Francophone Africa Blood services during the last 5 years and national and regional services likely have better indicators than hospital‐based services. These findings may support the need for ongoing blood safety initiatives.

Blood donations

10.1111/vox.12702

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Citations (15)

Serological detection strategy and prevalence of HIV and Viral Hepatitis B and C in blood donors in Yaoundé Cameroon

Dr Diderot Fopa Daniel Candotti Claude Tayou Tagny Edward L. Murphy Syria Laperche

BACKGROUND. The high prevalence of transfusion-transmissible infections (TTIs) is the most important challenge of safe blood supply in Cameroon. The seroprevalence of Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human immunodeficiency virus (HIV) was determined among prospective blood donors at blood bank Yaoundé University Teaching Hospital (YUTH), Yaoundé, Cameroon. MATERIAL AND METHODS. Blood donors were consecutively screened for HBV, HIV and HCV infections (Murex HBsAg Version 3, Murex HIV Ag/Ab Combination, and Murex HCV Ag/Ab Combination [DiaSorin]). Additional HBV testing including anti-HBc (Monolisa Anti-HBc PLUS; BIO-RAD) were performed. HIV and HCV serology were confirmed with HIV BLOT 2.2 (Genelabs Diagnostic) and INNO-LIA HCV (Fujirebio), respectively. RESULTS. In total, 1.162 donors were serially included in the study. Screening for viral infections showed that 91 (7.80%) of total sample donations were reactive for HBsAg+, 14 (1.2%) for HIV+, 11 (0.95%) for HCV+, and 1 (0.08%) for HBsAg+ and /HIV+. Screening samples for total Anti-HBc IgG+IgM revealed that 613(52.75%) samples were reactive. All of the 91 samples positive HBsAg positive were also positive for HBcAb. In the 1071 HBsAg negative participants, the prevalence of HBcAb was 48.7% (n=522). In seronegative participants for HBsAg, HCV and HIV, the prevalence of HBcAb was 48.8% (n=511). Testing of 13 HIV and 9 of HCV reactive samples revealed that 4 and 3 were confirmed positive by western blot, respectively. DISCUSSION. This study clearly showed a high prevalence of viral infections among Cameroonian blood donors at the YUTH. Strategies to increase voluntary and regular donors should be intensified to improve the medical selection of blood donors and reduce the frequency of TTIs found in donated blood. The confirmatory results of HIV and HCV underline the need to re-evaluate viral infection prevalence in Cameroonian blood donors.

Seroprevalence

Hepatitis C

Hepatitis B

10.32388/s0o5vb

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