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I checked the reference from the ALX148 web site and it is bound to an IgG1 frame so the lack of anti-IgG4 in the Immucor -IgG reagents is not going to work. ALX148 blocks CD47 and enhances innate and adaptive antitumor immunity with a favorable safety profile. Kauder SE1, Kuo TC1, Harrabi O1, Chen A1, Sangalang E1, Doyle L1, Rocha SS1, Bollini S1, Han B1, Sim J1, Pons J1, Wan HI1. Author information Abstract CD47 is a widely expressed cell surface protein that functions as an immune checkpoint in cancer. When expressed by tumor cells, CD47 can bind SIRPα on myeloid cells, leading to suppression of tumor cell phagocytosis and other innate immune functions. CD47-SIRPα signaling has also been implicated in the suppression of adaptive antitumor responses, but the relevant cellular functions have yet to be elucidated. Therapeutic blockade of the CD47 pathway may stimulate antitumor immunity and improve cancer therapy. To this end, a novel CD47-blocking molecule, ALX148, was generated by fusing a modified SIRPα D1 domain to an inactive human IgG1 Fc. ALX148 binds CD47 from multiple species with high affinity, inhibits wild type SIRPα binding, and enhances phagocytosis of tumor cells by macrophages. ALX148 has no effect on normal human blood cells in vitro or on blood cell parameters in rodent and non-human primate studies. Across several murine tumor xenograft models, ALX148 enhanced the antitumor activity of different targeted antitumor antibodies. Additionally, ALX148 enhanced the antitumor activity of multiple immunotherapeutic antibodies in syngeneic tumor models. These studies revealed that CD47 blockade with ALX148 induces multiple responses that bridge innate and adaptive immunity. ALX148 stimulates antitumor properties of innate immune cells by promoting dendritic cell activation, macrophage phagocytosis, and a shift of tumor-associated macrophages toward an inflammatory phenotype. ALX148 also stimulated the antitumor properties of adaptive immune cells, causing increased T cell effector function, pro-inflammatory cytokine production, and a reduction in the number of suppressive cells within the tumor microenvironment. Taken together, these results show that ALX148 binds and blocks CD47 with high affinity, induces a broad antitumor immune response, and has a favorable safety profile.

Yes, there are regulations for managing controlled documents for all manufacturers. Like Transfusion SOPs, they have to be put in a permanent archive so there is always a record of the instructions given to customers during a specific time period. In the actual packaging area, there is an SOP-guided process for removing and destroying excess old inserts, once the new insert is approved for use. These usually have a "go live" date like other controlled processes.

It will be lovely to see your smiling face Or you can do what I do. Use a picture of yourself when (in your opinion) you looked your best. Mine has to be at least 20yrs old. No sense going too young - then absolutely no one would recognize me . Although..... anonymity has its appeal. Especially after an episode of "foot in mouth"

That's marvelous! What good sense these organizers have in providing a wider range of speakers!! After you've given the talk on Henry, could you share some of it with those of us that can't get to RI ? I'm going to try to get there but you know what budgets are like - one minute you have it and the next it has gone up in smoke

By all means Tricore, please drop them off at your local used books rather than trashing them. I've got the older versions in the library here so I don't need them. They can still be useful reference sources for folks just starting out in Serology. And they are not likely to cause the hernia Peter thought might result from lugging the fourth edition around.

Sorry sweetie! I thought you were already in consulting mode I never thought you'd abandon us. I certainly won't. I'm not sure about assessing but I'll keep up the lecturing, editing, meetings and fun stuff. I've not set a date yet but it will definitely be in the next 5 yrs. Sooner if health limits me but I 'm working on that.

I've got mine with both signatures safe and sound The original sold for around $350USD so I can't imagine anyone dropping under that for a used version when they know there's a market.

Just a matter of being in the right place at the right time. I'm getting ready to bail and Malcolm has retired so just think of all the stuff that is going to happen that you'll see and we'll just audit. Get out to the meetings if you can and talk to the speakers. It's an interesting time to be in this field

Works for me. I'll talk to Laurie Munk at AABB and see if there's a good way to get the word out about a sign-up sheet. And make sure I'm not breaking any association rules.. I hadn't heard about Marion Scott retiring!! I was talking to Jill Storry last week and she told me about attending Geoff's party. It is frightening - everyone I trained with has retired. Of course, a lot of the Canadians could bail at 55 so that's not fair I feel like a dinosaur at AABB. So many new faces! Will keep you posted as I get information

And retired or not, Joyce is still doing technical editing with me for the ARC Immunohematology journal. She's a riot - loves to pull my husband's chain every time I drag him to a meeting with me. Definitely on my list of top serologists I've worked with in any capacity. Malcolm, I agree with you about Geoff's speaking style - like our late George, he's so comfortable doing it and easy to listen to. I was so glad he carried on with the Race and Sanger book. I heard he had a very nice retirement party this past Feb? or Mar? I met Ruth once through Margery Stroup. What a pair!! Living on this side of the pond, we didn't get many chances to actually meet the greats that stayed on your side. The British Invasion of the 70's gave us a huge boost and more opportunities to work up interesting cases. A poll if large enough would give us some clout when trying to scout up sponsors. But I've no idea how to go about that. Maybe a sign-up sheet at the AABB in Orlando? It could be posted near the computer access area and folks could sign for themselves and friends who aren't attending this year. The original book sold for $350 USD I think. If we could keep it in that ballpark maybe more folks could manage? If we could just get an idea of the size of the market... We've got so many generalists that could really use the help but I'm not sure about how to reach them. Any and all suggestions welcome!!!

Well, I tried. As you anticipated Malcolm, Peter doesn't think there is a big enough market for the book to make another printing worthwhile. He was also rather surprised that folks would want it considering how out of date the molecular info is. We have come so far so fast in that area since the book came out. He mentioned that Geoff Daniel's book is more recent and still available. In my opinion Geoff's book is much dryer in tone (still excellent in content) and I'm not sure how well many of the generalists would do with it. Peter's was written with a lighter tone and is much easier to digest. I also asked about finding group(s) willing to contribute to sponsor a printing such as AABB or one of our reagent suppliers. Peter thought that was highly unlikely. Do we have any idea how many copies we could guarantee? I think the whole idea will hang on making it financially feasible. Anyone got any ideas??

Hi guys, I was down to Supply this past weekend and saw the "old guys". They're doing well. I never thought to ask Peter about the 4th edition or if he'd consider a reprint. Linda is doing some great catering and Peter golfs whenever... I can certainly call and find out if there's a chance of resurrecting Montgomery Scientific for one last round. There isn't another reference book with as thorough a grounding in serology. Will let you know what he says

Just to clarify a few misconceptions: 1. Once a package insert change has been approved and new stock is in, IT IS SOP-driven that all old versions are destroyed and not used in new packages. If you ever get 2 packages of the same product with different version inserts - report it immediately to the company. Major labeling booboo! 2. Changes in inserts are marked as changed until the next revision when those changes become what is marked and the previous set become repeated text. You never know how long it can be between product orders so a customer may not get a revised insert until they order the same product 2yrs later. The changes are tied to the revision number and at any point can be identified for lookbacks. 3. Any change in insert must be approved by the FDA as this is a labeling issue and part of the license. This is not a free process. Any company makes sure the change is necessary and cost-effective within their Regulatory budget before making it. So small word change requests to "clarify" in the users' opinion are not likely to happen until the cost, changes and patient testing impacted make sense. 4. The 6 - 12 month timeline is usually correct. as is the large amount printed for cost containment. It really hurts when branding or reagent changes happen and the Materials Management group just ordered a huge number of inserts which must now be destroyed. Hope this helps

Hi Kelli, I'm so excited to hear you are writing an article for Transfusion. Finding time to write is a challenge. I wouldn't worry about a professional reviewer as the Transfusion staff will edit your article to comply with the Transfusion Style Guide. As one of the former Technical Editors for Transfusion, I'm very familliar with the process. The journal's website which you can access through AABB.org, has instructions for authors that will cover how they would like you to organize your paper (Case Review or original work, etc) and the steps for electronic submission of the file once you are ready for the peer review process to start. The peer reviewers are only supposed to look at content and how you drew conclusions from your results. They will submit questions back to you if it is felt there is more explanation or data needed. This is meant to be a supportive, collaborative process so please do not take any of the comments personally. They are meant to help you look good as an author. When content is settled, the technical editing staff for the journal will will work on your paper to make it comply with the Transfusion Style Guide and send you proofs before anything is printed. They do all the heavy work as far as grammar and formatting are concerned. They will make sure your data is presented in the clearest way possible and that your intended message is delivered correctly. You will be involved in the process but not completely responsible for it so don't worry! Any questions or concerns, I'm happy to help.

Folks, You're falling behind the times. (Malcom you're in the clear in the UK) The commentary published in last March in Transfusion has snowballed at every meeting since. AABB, ARC, ABC, Armed Services Blood Program , CAP, and Am College of Ob/Gyn(ACOG) have all come to terms on a recommended workflow for managing any D typing that does not conform to a clear D+. The AABB meeting in Anaheim was loaded with Technical and Scientific presentations to push this agenda. ACOG has devoted an issue of their journal to educate the docs most affected by the change in reporting. (Glory Halelujah) Even the CMS reimbursement and coding was thoroughly discussed. Which is the crux of the matter for those of us working in hospitals. Sure we'd love to know which weak D patient was Type I, 2 or 3 so we could save our RhIg & D- units but at what cost to our operating budget? This is the time for us to take control of a change we won't be able to avoid forever. There is a licensed product on the market but it isn't a perfect fit for what we need now. We need to push back at the manufacturers(tell any sales rep that tries to push molecular testing) We need to tell them we'll look at this IF they design the product we need to identify D genotypes and make it cost effective. Otherwise it would cost us way too much in training, equipment, proficiency and competency programs to manage full genotyping which we don't need. And for some of the smaller hospitals that might use it once or twice a month, totally negates any saving they would see in RhIg and D- blood. If the Powers that Be are pushing this agenda and they do not want serologic weak D testing reinstated, then they need to get with the program and support our concerns. Otherwise D typing will remain the muddled mess on a seesaw that it has been for the last 40yrs. Just my opinion