Joseph Schwartz

Joseph Schwartz
Columbia University | CU

About

200
Publications
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6,044
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Publications

Publications (200)
Article
Although altruistic regular blood donors are vital for the blood supply, many become iron deficient from donation-induced iron loss. The effects of blood donation-induced iron deficiency on red cell transfusion quality or donor cognition are unknown. In this double-blind, randomized trial, adult iron-deficient blood donors (n=79; ferritin <15 mg/L,...
Article
Background aims This white paper was developed to provide leukapheresis guidance for the collection of mononuclear cells from adult and pediatric patients who are destined for immune effector cell (IEC) therapies for commercial and research applications. Currently, there is considerable variability in leukapheresis processes and limited published i...
Article
Background: Chimeric antigen receptor T (CAR-T) cell successes have encouraged continued clinical study. Apheresis collection of starting material for CAR-T cell therapy product manufacturing is critical but described approaches suggest variability and clinical guidelines are currently lacking. The goal of this study was to gather and assess varia...
Article
Full-text available
Background: Although convalescent plasma has been widely used to treat severe coronavirus disease 2019 (COVID-19), data from randomized controlled trials that support its efficacy are limited. Methods: We conducted a randomized, double-blind, placebo-controlled trial among adults hospitalized with severe and critical COVID-19 at five sites in Ne...
Article
Context.—: Modern RHD genotyping can be used to determine when patients with serologic weak D phenotypes have RHD gene variants at risk for anti-D alloimmunization. However, serologic testing, RhD interpretations, and laboratory management of these patients are quite variable. Objective.—: To obtain interlaboratory comparisons of serologic testi...
Article
Context.— ABO mistransfusions are rare and potentially fatal events. Protocols are required by regulatory agencies to minimize this risk to patients, but how these are applied in the context of massive transfusion protocols (MTPs) is not specifically defined. Objective.— To evaluate the approaches used by transfusion services for switching from un...
Preprint
Background: Although convalescent plasma has been widely used to treat severe coronavirus disease 2019 (COVID-19), data from randomized controlled trials that support its efficacy are limited. Objective: To evaluate the clinical efficacy and safety of convalescent plasma among adults hospitalized with severe and critical COVID-19. Design: Randomize...
Article
Full-text available
Objectives The aim of this study is to evaluate the efficacy and safety of human anti-SARS-CoV-2 convalescent plasma in hospitalized adults with severe SARS-CoV-2 infection. Trial Design This is a prospective, single-center, phase 2, randomized, controlled trial that is blinded to participants and clinical outcome assessor. Participants Eligible...
Article
Full-text available
Background Blood suppliers and transfusion services have worked diligently to maintain an adequate blood supply during the COVID‐19 pandemic. Our experience has shown that some COVID‐19 inpatients require transfusion support; understanding this need is critical to blood product inventory management. Study Design and Methods Hospital‐wide and COVID...
Article
Full-text available
As part of the ZOOMICS project, we set out to investigate common and diverging metabolic traits in the blood metabolome across various species by taking advantage of recent developments in high-throughput metabolomics. Here we provide the first comparative metabolomics analysis of fresh and stored human (n = 21, 10 males, 11 females), olive baboon...
Article
Background Entrustable professional activities (EPAs) are well‐defined, executable, observable, and measurable activities that are performed by a trainee and can be performed independently as training progresses. The purpose of this study is to develop EPAs specific for the practice of apheresis medicine (AM). Methods Members of the American Socie...
Article
Since 1986, the American Society for Apheresis (ASFA) has published practice guidelines on the use of therapeutic apheresis in the Journal of Clinical Apheresis (JCA) Special Issue. Since 2007, updated guidelines have been published every 3 years to reflect current evidence based apheresis practice with the most recent edition (8th) published in 20...
Article
Objective Apheresis platelets are a product with high cost and limited supply commonly used for hematopoietic transplant patients. There is potential for both transfusion reactions and refractoriness associated with this product. Therefore, transfusion guideline compliance is closely monitored. Methods This is a quality assurance review of a prosp...
Article
Background: The AABB Clinical Transfusion Medicine Committee (CTMC) compiles an annual synopsis of the published literature covering important developments in the field of transfusion medicine (TM) for the board of director's review. This synopsis is now made available as a manuscript published in TRANSFUSION. Study design and methods: CTMC comm...
Article
Full-text available
BACKGROUND Glucose-6-phosphate dehydrogenase (G6PD) deficiency decreases the ability of red blood cells (RBCs) to withstand oxidative stress. Refrigerated storage of RBCs induces oxidative stress. We hypothesized that G6PD-deficient donor RBCs would have inferior storage quality for transfusion as compared with G6PD-normal RBCs.METHODS Male volunte...
Article
Importance: Neuromyelitis optica/neuromyelitis optica spectrum disorder patients' response to therapeutic plasma exchange (TPE) is currently incompletely characterized. Objective: Our study aims to understand the clinical status improvement of neuromyelitis optica/neuromyelitis optica spectrum disorder patients treated with TPE. Design, setting...
Article
Background: A small body of literature assessing the efficacy and safety of pathogen reduced (PR) plasma has been published. Study design and methods: An AABB committee systematically reviewed the literature and graded the clinical trial evidence with the assistance of a GRADE expert. Results: Most studies identified were low quality and had a...
Article
Background: Despite fulfilling all requirements for blood donation, a large proportion of regular blood donors are iron deficient. Red blood cells (RBC) from iron-deficient donors may be particularly susceptible to damage induced by standard refrigerated storage. Herein, we present a study protocol for testing whether correcting iron deficiency in...
Article
BACKGROUND The AABB compiles an annual synopsis of the published literature covering important developments in the field of transfusion medicine. An abridged version of this work is being made available in TRANSFUSION, with the full‐length report available as Appendix S1 (available as supporting information in the online version of this paper). ST...
Article
BACKGROUND The chromium‐51–labeled posttransfusion recovery (PTR) study has been the gold‐standard test for assessing red blood cell (RBC) quality. Despite guiding RBC storage development for decades, it has several potential sources for error. METHODS Four healthy adult volunteers each donated an autologous, leukoreduced RBC unit, aliquots were r...
Article
The American Society for Apheresis (ASFA)regularly publishes evidence-based guidelines, with the most recent edition in 2016, to assist the requesting and/or apheresis physicians with the evaluation of therapeutic apheresis. Given that therapeutic plasma exchange (TPE)is one of the most common therapeutic apheresis procedures, in this review, we di...
Article
Full-text available
Success and safety of autologous stem cell transplant (ASCT) is contingent on collecting enough CD34+ cells. CXCR4 antagonists (plerixafor) can increase the success and efficiency of stem cell mobilization. Plerixafor has been increasingly used but concerns remain about its cost and logistics of administration. We report our experience with plerixa...
Article
Full-text available
Engraftment syndrome (ES) after autologous stem cell transplant (ASCT) is characterized by non-infectious fevers, skin rash, hypoxia, acute kidney injury (AKI) among other signs and is defined by the Spitzer or Maiolino criteria. It is a significant cause of morbidity and rarely mortality; risk factors and etiology are poorly understood. We sought...
Article
Background and Objectives Passive transfusion reaction reporting systems fail to capture a significant number of reactions, and no data exist on provider reporting trends. The aim of this study was to describe transfusion reaction reporting patterns by adult and paediatric providers. Materials and Methods This is a multihospital study on transfusi...
Article
The Choosing Wisely campaign has stimulated clinicians to think about the appropriateness of various tests and procedures, compelling physicians to make smarter, safer and more effective choices for high quality patient care and to reduce healthcare cost. The American Society for Apheresis (ASFA) strives to advance apheresis medicine through educat...
Article
The increasing incidence of placenta accreta has paralleled the rise in its greatest risk factor: cesarean delivery. In placenta accreta, the abnormal invasion of the chorionic villi into the myometrium prevents separation of the placenta at delivery, and the myometrium is unable to contract to prevent hemorrhage. Spontaneous uterine rupture and he...
Article
Background: The AABB compiles an annual synopsis of the published literature covering important developments in the field of Transfusion Medicine. For the first time, an abridged version of this work is being made available in TRANSFUSION, with the full-length report available as an Appendix S1 (available as supporting information in the online ve...
Article
Transfusion of blood components is a complex multidisciplinary process from provider order, to blood bank processing, to administration. Errors at any of these points can result in great harm to the patient. Given the complexity and high-risk process of blood ordering, one of our 2016 quality and patient safety (QPS) goals was to conduct a proactiv...
Chapter
Hematopoietic cell transplantation is a lifesaving therapy. Almost 20,000 transplants were performed in the United States in 2014. Transplantation is used to treat a wide variety of diseases, most commonly leukemias, lymphomas, multiple myeloma, and certain solid tumors. Hematopoietic graft sources include bone marrow, peripheral blood, and cord bl...
Chapter
Cellular therapy products are highly regulated in the United States both at the state and federal levels. The Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) are the main governing bodies that provide federal oversight. State health departments may also have local regulations for processing laboratories. Indi...
Chapter
Cellular therapy is quickly becoming an integral part of transfusion medicine practice. Therefore, transfusion medicine professionals are required to be familiar with the practice of manufacturing therapeutic cellular products for clinical use. This chapter is designed with practical questions allowing for comprehension of the fundamental knowledge...
Book
This concise book examines clinically relevant issues relating to the ways in which bone marrow, cord blood and apheresis products, are processed and stored for the purpose of Hematopoietic Cell Transplantation and Cell Therapy. The twin aims are to offer up-to-date content covering a wide spectrum of topics and controversies and to provide practit...
Article
Full-text available
Context: - Cytomegalovirus (CMV) can be transmitted by cellular blood products, leading to severe disease in immunosuppressed patients such as neonates and transplant recipients. To mitigate transfusion-transmitted CMV (TT-CMV), "CMV-safe" blood products (leukoreduced and/or CMV-seronegative) are transfused. Attempts to develop practice guidelines...
Article
In adults, extracorporeal photopheresis (ECP) is widely utilized for a variety of indications, most commonly cutaneous T-cell lymphoma, acute or chronic graft-versus-host disease (GVHD), solid organ transplant rejection, and other autoimmune and T-cell-mediated disorders. In pediatric patients, the majority of case series and reports have focused o...
Article
Full-text available
Background: Some countries have limited the maximum allowable storage duration for red cells to 5 weeks before transfusion. In the US, red blood cells can be stored for up to 6 weeks, but randomized trials have not assessed the effects of this final week of storage on clinical outcomes. Methods: Sixty healthy adult volunteers were randomized to...
Article
Apheresis Medicine is a medical discipline that involves a variety of procedures (based on the targeted component to be removed or collected), indications (therapeutic vs. donation), and personnel (operators, management, and medical oversight). Apheresis services are accredited and/or regulated by a number of agencies. Given the complexity and the...
Article
FACT-JACIE cellular therapy standards are being revised every 3years and currently in their 6th edition. Significant changes in the 6th edition of the standards that affect apheresis facilities participating in cellular therapy product collections are presented.
Article
Graft-versus-host disease (GVHD) is a complication of allogeneic hematopoietic stem cell transplantation with high morbidity and mortality. Extracorporeal photopheresis (ECP) is an effective therapy for treating medication-refractory GVHD, however, there is scant evidence of whether ECP can be safely performed in patients weighing less than 15 kg....
Article
Purpose of review: Therapeutic apheresis can be used to treat many diseases. The American Society for Apheresis (ASFA) publishes Guidelines on the use of therapeutic apheresis every 3 years with the goal of providing the best available evidence for apheresis practice as well as clinical expertise. The 2016 (7th ed.) ASFA Guidelines contain 87 dise...
Article
The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications for the evidence-based use of therapeutic apheresis in human disease. Since the 2007 JCA Special Issue (Fourth Edition), the Committee has incorporated systematic review and...
Article
Background: Fibrinogen repletion in patients with acquired bleeding disorders can be accomplished by transfusing cryoprecipitate AHF (cryo) or fibrinogen concentrate (FC); thus, we undertook an economic evaluation from the transfusion service perspective regarding the use of cryo vs. FC in patients with acquired bleeding. Methods: We created a m...
Article
Objective: Little is known about the relationship of perceived racism to ambulatory blood pressure (ABP) in Hispanics. We explored possible associations between ABP nocturnal dipping and perceived racism in a Hispanic cohort. Methods: Participants included 180 community-dwelling Hispanics from the Northern Manhattan Study. Measures included perc...
Article
Background: Anti-muscle specific kinase antibody positive (MuSK Ab) myasthenia gravis (MG) patients are known to have different clinical course compared to anti-acetylcholine receptor Ab positive MG patients. Therapeutic plasma exchange (TPE) has been reported to be effective; however, little is known of the response and of TPE procedural informat...
Article
Purpose: Hematopoietic Progenitor Cell (HPC) collection by apheresis is performed in patients and donors to obtain HPCs for transplantation. Although studies have shown these procedures to be safe, successful collection cannot be performed without establishment of venous access. This project's objective was to ascertain the current practices of do...
Article
The standard therapy for patients with chronic pancreatitis (CP) and severe abdominal pain is total pancreatectomy (TP) followed by islet autotransplantation (IAT) to prevent the development of brittle diabetes. In adult patients, narcotic independence is achieved in up to 73% of patients 1 to 5 years after transplantation whereas insulin independe...
Article
Wilson's disease is a rare autosomal recessive genetic disorder that results in accumulation of copper in the liver, brain, cornea and kidney. Therapeutic plasma exchange (TPE) has been used to remove copper and provide a bridge to liver transplantation. We report here the collective experiences through the ASFA apheresis registry on Wilson's disea...
Article
Hyperleukocytosis can induce leukostasis, which can lead to vascular obstructions (usually in the lungs and central nervous system), tumor lysis syndrome, and disseminated intravascular coagulation. Although it has not been conclusively shown to improve long-term outcome, leukocytapheresis may be used as part of the management of hyperleukocytosis...
Article
Primary immune thrombocytopenia (ITP) is an autoimmune disease that affects children and adults. WinRho SDF is a D immune globulin product that is Food and Drug Administration approved for the treatment of ITP in D+ pediatric and adult patients. WinRho is a plasma-derived biologic product dispensed from blood banks. Transfusion medicine physicians...
Article
Therapeutic apheresis (TA) is a treatment modality currently being used in many disease conditions. However, the decision to treat a patient with TA depends on many factors, including but not limited to the most likely diagnosis the patient has and whether there is a rationale for TA to be used as a treatment modality, the risk versus benefit ratio...
Article
Full-text available
IntroductionPaediatric apheresis (PA) has distinct characteristics compared to adult apheresis and requires specialized knowledge and experience to perform safely, particularly in low-weight patients. As evidence-based medicine advances the field of therapeutic apheresis, increased attention must be paid to paediatric patients with conditions for w...
Article
Background Cyclophosphamide-based conditioning regimens and allogeneic hematopoietic stem cell transplantation (AlloHSCT) from matched related donors (MRD) has resulted in the highest survival rates in children and adolescents with acquired severe aplastic anemia (SAA). Time to transplant has consistently been associated with decreased overall surv...
Article
Full-text available
Background Patients with abnormal placentation are hospitalized approximately 21 days prior to scheduled delivery due to risk of peri-partum bleeding. It is required to have at least one red blood cell (RBC) unit ready throughout hospitalization. This can be accomplished by performing a type and cross (T&C) every 72 h (traditional method) or provid...
Article
BU and CY (BU/CY; 200 mg/kg) before HLA-matched sibling allo-SCT in children with sickle cell disease (SCD) is associated with ~85% EFS but is limited by the acute and late effects of BU/CY myeloablative conditioning. Alternatives include reduced toxicity but more immunosuppressive conditioning. We investigated in a prospective single institutional...
Article
Background Plasma constituents have been implicated in some types of platelet (PLT) transfusion reactions. Leukoreduced apheresis PLTs stored in InterSol have 65% less plasma than apheresis PLTs stored in 100% plasma (PPs). This study compared transfusion reaction rates in InterSol PLTs (PLT additive solution [PAS] C) versus PPs.Study Design and Me...
Article
Full-text available
Introduction: Pediatric apheresis (PA) has distinct characteristics compared to adult apheresis, and requires specialized knowledge and experience to perform safely, particularly in low-weight patients. As evidence-based medicine advances the field of therapeutic apheresis, increased attention must be paid to pediatric patients with conditions for...
Article
Full-text available
Both plasma- and recombinant activated factor VII (rFVIIa)-based algorithms can be used to correct coagulopathy in preliver transplant patients with acute liver failure requiring intracranial pressure monitor (ICPM) placement. A decision model was created to compare the cost-effectiveness of these methods. A 70-kg patient could receive either 1 rou...
Chapter
Therapeutic plasma exchange is a procedure in which the patient’s plasma, which contains pathogenic substances (such as pathogenic antibodies), is replaced with plasma or albumin in order to treat a disease. Examples of diseases treated by plasma exchange include thrombotic thrombocytopenic purpura, myasthenia gravis, and chronic inflammatory demye...
Article
The decision to treat a patient with therapeutic apheresis depends on multiple factors, such as what does the patient most likely have, is the diagnosis amenable to apheresis treatment, what is the harm-versus-benefit ratio of apheresis treatment in this patient, and what are the internal and external issues associated with receiving apheresis trea...
Article
Introduction Transfusions of packed red blood cell (pRBC) units to infants in Neonatal Intensive Care Units (NICUs) may predispose neonates to healthcare-associated infections (HAIs). We compared neonatal pRBC transfusion practices at four NICUs (Morgan Stanley Children’s Hospital of NewYork-Presbyterian, Columbia University Medical Center, Komansk...