In transfusion medicine the scientific fundamentals of immunology have
had a considerable clinical impact. Transfusion may suppress the
immunity but some patients could suffer disadvantages including GvHD,
alloimmunisation and possible cancer, where white cells (WBC) play
pivotal roles in this phenomenon, presenting antigens and producing
cytokines. A clinical application of this practice is LAK-cells targeted
against cancer. MHC on the WBC may provide additional immunological
modulations through series of secondary messengers. Thus reduction of
WBC in the blood and bone marrow may be advantageous for patients. On
the other hand, sharing a part of MHC or making the transplanted white
cells anergic by storage may be even more advantageous for patients. CMV
infection could mimic part of this MHC.
UV radiation is effective in the inactivation of the WBC although
filters are easy means for such removal. However, their accurate
quantification requires flow cytometry that has considerable potential
application in blood transfusions. Idiotypic antibody could play an
important role in platelet theory. However, the potential infection
risks in transfusion like HIV and HCV remain, but application of
molecular biological methods like PCR or RT/PCR has great potentials in
detection of infectious diseases, transplantation and genetic disorders.
Immuno affinity purified concentrates, like factor IX and protein C,
could reduce patients' immune functions, where in the future protein C
could be derived from transgenic animals. Advances are sure to emerge
through adoptive immunotherapy and gene therapies are exciting prospects
when genes transferred into lymphocytes could be used to correct cell
mediated immune deficiency, as in ADA.