I: Fundamental Aspects of Cytokines and Growth Factors. The Role of the Common Gamma Chain of the IL-2, IL-4, IL-7 and IL-15 Receptors in Development of Lymphocytes. Constitutive Expression of Bcl-2 Does not Rescue the Developmental Defects in Gamma Common-Deficient Mice; H. Spits. Molecular Mechanisms Involved in the Control of Differential Cytokine Expression in Human Monocytes; E. Vellenga. Signal Transduction from the Haematopoietic Growth Factor Receptors; I.P. Touw. Recipient Immune Responses Induced by Allogeneic Whole Blood or Platelet Transfusions: Implications for Immunomodulation; J.W. Semple. II: Role and Function of Cytokines and Growth Factors in the Blood Bank. Use and Application of Cytokines and Growth Factors in Laboratory Diagnostic Procedures; M. Fujihara. Ex vivo Cytokine Production in Blood Components: Relevant or Irrelevant? L. Muylle. Haematopoietic Growth Factors for the Expansion of Peripheral Blood Progenitor Cells; T.A. Block. Gene Marking and Gene Therapy for Transplantation Medicine; D.R. Rill. Ex vivo Culture and Expansion of Haematopoietic Progenitor Cells in Cancer Patients; R. Mertelsmann. Peripheral Blood Progenitor Grafts obtained from Healthy Donors; P. Dreger. III: Role and Application of Cytokines and Growth Factors in Clinical Medicine. Clinical Relevance of Cytokine Levels in Blood Products: Evidence to Correlate with Morbidity; N.M. Heddle. Ablative Chemotherapy in Solid Tumour Oncology, Technology in Search of an Application? N.M. Mulder. Gene Therapy in Malignancies: Development and Clinical Applications of Autologous Tumour Vaccines; J.I. Drayer. Vaccination Strategies to Induce T-cell Immunity against Tumours; R.E.M. Toes. Cytokines in the Treatment of Infection; D.C. Dale. Thrombopoietin: Biological Effects Beyond Megakaryopoieses; K. Kaushansky. IV: Future Potential of Cytokines and Growth Factors in Transfusion Medicine. Erythropoietin &endash; Where Do We Go From Here? L.T. Goodnough. Ethical Aspects of the Use of Cytokines and Growth Factors in Donors; H.M. Dupuis. Future Potential of Cytokines and Growth Factors in Transfusion Medicine: What New Horizons are There to Come? B. Löwenberg. Index.
Cytokines are cellular growth factors which also provide communication between cells and their milieu. This clearly is an exciting area in modern medicine that will have significant impact on various facets of transfusion. Erythropoietin therapy stimulates red cell production while thrombopoietin seems to positively affect megakaryopoiesis and can be an added armamentarium for the thrombocytopenic patient.
Using haematnopoietic growth factors, stem cells could be mobilized early to the peripheral blood for collection and subsequent transplantation into haemato-oncology patients instead of bone marrow transplantation. Using a cocktail of cytokines in cell culture, stem cells could be expanded and selected for therapy. Cytokines and growth factors can even be modified, which may lead to successful gene therapy in malignancies, including solid tumour vaccines. However, the presence of cytokines in certain blood products could have biological effects following transfusion, although its clinical relevance needs to be ascertained. There is much potential for the use of cytokines in the treatment of infections. Early diagnostic methods are now available to monitor their levels and relevance. It is likely that cytokines will increasingly play a role in therapy and could develop our fundamental knowledge about the development of T-cells. An ethical dilemma remains, however, regarding the use of cytokines in healthy donors for harvesting suitable specific cells. Longer clinical observation will be necessary to gather the necessary information.
Cytokines and growth factors in blood transfusion was the theme of the 21st International Symposium in Blood Transfusion, where twenty clinicians and scientists, experts in their own fields, were invited to update the above information. Their findings are presented in four sections in this volume: Fundamental aspects - cytokines in development of T-cells, g
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