Indian Journal of Hematology and Blood Transfusion最新文献

The main aim of this study was to assess the health literacy level among blood donors and contrast it with the health literacy level observed within the general community. The study encompassed blood donors aged 18 years and older who presented themselves to the Erciyes University Blood Center within the period from February 10, 2023, to April 1, 2023. A questionnaire form including sociodemographic characteristics and the Turkish Health Literacy Scale was utilized. Independent T Test and One Way ANOVA were employed to compare the mean scores of the health literacy scale across independent groups. The mean health literacy scores of the general population in Turkey and blood donors were compared using the one-sample T test method. The percentage of participants demonstrating adequate or excellent health literacy was found to be 53%. The health literacy score of blood donors was 34.64 (95% CI: 33.9–35.4), significantly higher than the general health literacy score of 29.5 (95% CI: 28.8–30.3) in Turkey (p < 0.001). The health literacy level of blood donors was found to be higher compared to the general population. The principal reason for this could be the inclination of individuals leading a healthy lifestyle to donate blood out of concern for the health of others and their inherent tendency to exhibit benevolent behavior. Consistent with the findings of the study, we posit that health literacy can indeed play a pivotal role in augmenting the number of blood donors.

We planned to assess iron overload in young transfusion-dependent thalassemia (TDT) patients with T2* MRI and correlate with serum ferritin. This study included young TDT patients aged 3 to 38 years on regular transfusion in a tertiary care facility from July 2017 to December 2018. T2* MRI was performed on all patients and correlated with serum ferritin values. Out of 193 cases over a period of one and half year, 26 (13.4%) cases showed mild, 48 (24.8%) moderate, and 92 (47.6%) cases showed severe hepatic iron overload. Cardiac iron overload detected none in 129, mild in 21, moderate in 12, severe in 31 patients. Pancreatic iron overload was observed none in 67, mild 35, moderate in 43, severe in 33 patients and could not be done in 15 patients. There is strong negative correlation between serum ferritin level and liver T2*. Moderate negative correlation of serum ferritin was found with cardiac T2*. Statistically significant difference was observed between pancreas iron overload and age group (P-value = 0.001). The results of this study are comparable with those of several earlier studies In addition, there is a significant correlation between serum ferritin levels and iron overload determined by T2* MRI data.

COVID-19 pandemic led to a decline in voluntary blood donations posing a risk of under-transfusion. This study aimed to evaluate and analyze the root causes of challenges from patients’ perspectives, helping blood centers achieve adequate blood supply during pandemics and catastrophes. The questionnaire included 15 questions, 10 of which were option-based. The first part collected demographic data and information on the type of blood component transfused. The second part evaluated the patient's thalassemia status, blood requirements, and how the COVID-19 pandemic impacted their needs. A response was considered valid if 80% of questions were answered. 280 thalassemia patients responded to the questionnaire receiving regular blood transfusions. During the pandemic, 217 patients needed transfusions less than once a month, 33 (12.5%) saw a decrease in transfusion frequency due to fears of infection, lack of transportation, and reduced needs. However, 7 (2.65%) saw an increase in transfusion frequency. The waiting time for blood also increased for 63.88% patients, by less than two hours for most. COVID-19 pandemic has significantly impacted thalassemia patients' routine activities, with only 12.5% of patients experiencing reduced transfusion visits due to fear of infection and limited transportation services. Blood donations decreased, but reduced elective surgeries helped balance out. Workforce shortages at blood centers and pandemic management diversions caused delays for some patients. Looking into the past catastrophe from the perspective of the sufferers, especially in thalassemia patients, will enable the policy makers to prepare an organogram to intercept any such future setback.

The survival of patients with transfusion-dependent thalassemia has increased with optimal blood transfusion. In adult patients with thalassemia, iron toxicity due to repeated blood transfusion is the main contributing factor causing decreased bone density and leads to mechanical disruption in the bone structure. This study aimed to analyze the variables affecting bone mineral density (BMD) in patients with thalassemia major. We enrolled patients with transfusion-dependent thalassemia who visited the Hasan Sadikin Hospital Bandung outpatient clinic. Participants underwent anthropometric measurement, laboratory, and BMD examination. Bivariate analysis was performed to determine the correlation between clinical data and BMD by Pearson or Rank–Spearman depending on data distribution. Multivariate analysis was performed to determine the most influential variables using linear regression analysis. p < 0.05 was considered statistically significant. Overall, 59 participants were included. BMD was significantly correlated with body mass index (BMI), sex, average pre-transfusion hemoglobin level, blood transfusion volume, and vitamin D, with coefficient r values of 0.47, 0.34, − 0.27, and − 0.28 (p < 0.05), respectively. BMI was the variable that most influenced BMD, with 0.39 coefficient value, an adjusted coefficient value of 0.32 (0.01–0.04), and p = 0.04. Receiver operating characteristic analysis showed BMI had the highest area under the curve (AUC) in all examination areas, especially in the hip area, with 0.800 AUC. 77.8% sensitivity, and 71.7% specificity. BMD was correlated with BMI, sex, average pre-transfusion hemoglobin level, blood transfusion volume, and vitamin D, with BMI being the most influential factor affecting BMD.

Bone marrow (BM) involvement in lymphoma is a known adverse prognostic factor. Bone marrow biopsy (BMB) is the gold standard for detection of bone marrow involvement but is invasive modality. Positron emission tomography with computed tomography (PET-CT) scan has the ability to assess bone marrow involvement. We aimed to assess the concordance of PET-CT for BM involvement with BMB. 75 consecutive newly diagnosed cases of lymphoma were enrolled and were assessed for BM involvement with PET-CT and BMB. Of 75 patients, eighteen patients (24%) had BM involvement, with 19% (n = 14) detected with BMB, and 13 (17%) with FDG PET CT. There was a concordance rate of 88% amongst PET-CT and BMB. It was 92% in Hodgkin's lymphoma (HL), 71.4% in non-Hodgkin's lymphoma (NHL), and 91% and 70% in high- grade (HG) and low- grade (LG) NHL, respectively. Sensitivity, specificity, PPV, NPV, and accuracy of PET-CT for study population were 69.23%, 93.44%, 69.23%, 93.44%, and 89.19% respectively. In patients with NHL sensitivity, specificity, NPV, PPV, and accuracy of PET-CT were 54.55%, 94.23%, 66.67%, 90.74%, and 87.30%, respectively; whereas in HL group these were 100%, 88.89%,75%, 100%, and 91.67%, respectively. PET-CT has got a high concordance with bone marrow biopsy in detecting bone marrow involvement with high specificity, NPV and accuracy. A high sensitivity, specificity, NPV and accuracy for detecting bone marrow involvement in patients with HL, aggressive B cell NHL, and T cell NHL was observed but the same parameters were not at par in patient with indolent NHL.

This study aims to explore the factors that affect the efficacy of apheresis platelet transfusion in patients with hematologic diseases and construct a nomogram prediction model to predict the possibility of obtaining satisfactory platelet transfusion efficacy and guide scientific and rational platelet transfusion. The basic information of 2,007 hematologic patients who received apheresis platelet transfusions from June 2022 to April 2023 and the corresponding donor information and apheresis platelet data are collected. The risk factors that cause ineffective platelet transfusions are screened through a logistic regression analysis. Then, the risk factors are introduced into R software, and a nomogram prediction model is established and validated. The regression analysis shows that the independent risk factors for ineffective platelet transfusion are platelet count before transfusion, white blood cell count, hemoglobin content and mean corpuscular hemoglobin, cumulative platelet transfusion times, platelet antibody positivity, fever, splenomegaly, graft-versus-host disease, bleeding, and platelet storage days. These factors are included in the nomogram, and the calibration curve for predicting transfusion efficiency reveals good consistency between the nomogram-predicted results and the actual observations. The area under the curve obtained through internal repeated sampling is 0.756. This study comprehensively assessed the risks associated with factors leading to ineffective platelet transfusion and successfully constructed and validated a nomogram prediction model. This model provides an important predictive tool for assessing the efficacy of platelet transfusion in patients with hematologic diseases, with the potential to guide scientific and rational platelet transfusion practices.

Purpose

The COVID-19 pandemic had a considerable impact on blood donations worldwide. The present study aims to empirically investigate the determinants of willingness to donate blood during the COVID-19 pandemic in Hungary. Methods Our study was carried out on 418 whole blood donors (286 women, 68.4%) using data collection from the online and paper self-report questionnaire data collection. We evaluated the association between motivation, self-efficacy, and technical and emotional barriers to donation. Results The correlational analysis showed that the number of donations during the COVID-19 pandemic was positively associated with the total number of donations; habit and identity motivation; and blood donation self-efficacy. In contrast, a negative association has been found with perceived barriers during the pandemic. The path model confirmed that the number of donations during the pandemic can be explained by the donors' habit and identity motivation facilitated by the experienced blood donation self-efficacy. The number of total donations also predicted the donations during COVID-19. Conclusion These findings suggest that high donor self-efficacy is associated with habitual donation and the need to reinforce donor identity, which may again positively influence the number of donations. These factors contribute to the continued willingness to donate and result in a stable blood supply even during a health crisis or other societal challenges. Our research fits into a series of studies that draw the attention of blood donation professionals to the importance of identifying and maintaining a motivational background, increasing self-efficacy, and removing barriers to blood donation.

The study aimed at evaluating the prevalence of IDH1 and IDH2 mutations in Indian AML patients and ascertaining its impact on the treatment outcomes. A retrospective cohort study was carried out from 2019 to 2023, where 100 AML patients were tested for the presence of IDH mutations. The clinical and laboratory parameters of the patients were analysed and compared with an age matched control group of IDH1/2 negative AML patients. Treatment outcome was also compared between the groups and overall survival (OS) was calculated with subgroup analysis of intensive chemotherapy vs. Hypomethylating agent (HMA) and Venetoclax therapy in the IDH1/2 mutated group. A total of 26 (26%) patients tested positive for IDH mutations (19 for IDH1 and, 6 for IDH2, and one for both). Coexistence of IDH mutation with NPM1 mutation was observed in 7 patients (26.9%) while 3 patients (11.5%) showed positivity for FLT3 mutations. Sixteen patients opted for therapy at our centre; of which 62.5% received intensive chemotherapy and 37.5% received hypomethylating agents and venetoclax. Relapse was seen in 31.2% vs. 18.7% and mean OS was 1.6 years vs. 2.5 years in the IDHmut vs. the control arm. Overall mortality was 37.5% in IDHmut as compared to 25% in the control arm. The study thus higlights that IDHmut AML patients had a higher relapse and poorer survival outcome when compared to the IDH negative control group.

Myeloma patients with high involved free light chains (iFLC) at diagnosis may exhibit a worse clinical course, independent of established prognostic factors. This study aimed to evaluate clinical and renal outcomes in Indian patients with baseline iFLC exceeding 1000 mg/L. All MM patients diagnosed between January 2021 and July 2023 with iFLC > 1000 mg/L were included with the primary and secondary objectives to describe overall survival (OS) and renal outcomes, respectively. Thirty-eight patients (M: F = 26:12) with a median age of 63 years were included. Renal impairment (eGFR < 40 ml/min) was present in 24 (63%) patients with a median eGFR of 9 (6-15.25). At diagnosis, median involved free light chain (iFLC) was 5262 mg/L (kappa: 1996 mg/L, lambda: 36 mg/dL). VCD was most frequent initial therapy (55%), followed by VRD (21%); 76% patients received Bortezomib. Ten patients (26%) required dialysis at presentation. At first reassessment after a median of 91 days, median eGFR was 36 ml/min/1.73m2. Of twenty assessable patients, one patient (15%) had partial renal response, and three (15%) each had complete and minimal response, respectively. After a median follow up of 38 months, median OS was 76 months (1- and 3-year survival: 78% and 54%). Dialysis independence was achieved in 60% of patients. There was no correlation between final serum creatinine and baseline value of iFLC. This study describes the first Indian data on patients with myeloma and high initial iFLC (> 1000 mg/L). Compared to published data, we observed a higher frequency of renal impairment, dialysis requirement, and shorter OS. Our data suggests a potential role between high iFLC and clinial outcomes, warranting further evaluation as its role as an independent risk factor.