Indian Journal of Hematology and Blood Transfusion最新文献

Apoptosis may disrupt differentiation of hematopoietic stem cells (HSCs), which can affect aging. Thus, the main goal of this study was to compare the effect of plasma exosomes from young and old people on the expression of Bcl-2-associated X (BAX) and B-cell lymphoma 2 (BCL-2) genes in the HSCs. Plasma samples were acquired from four elderly adults and four younger adults, referring to Blood Transfusion Organization of Tehran-Iran during August 2022– September 2022.Then, the exosomes of the samples were extracted and analyzed using DLS, TEM, and CD63 surface marker. HSCs were isolated from umbilical cord blood cells. The MTT test was used to assess the viability of exosomes-treated HSCs at doses of 5 and 10 μg/ml. The expression of BAX and BCL-2 genes in the cells was examined using real-time PCR. A one-way analysis of variance (ANOVA) was performed to examine the distinctions among five groups. The viability of HSCs was not affected by the exosomes from young and old people than the control group (P = 0.453). Exosomes from young people (doses 5 and 10 µg/ml) did not have any significant impacts on BAX (P = 0.746, and P = 0.345, respectively) and BCL-2 (P = 0.773, and P = 0.461, respectively) expression in the HSCs compared to the control group. The BAX gene was significantly upregulated and the BCL-2 gene was significantly downregulated after utilizing the exosomes derived from the plasma of elderly individuals (dose 10 µg/ml) compared to the control (P = 0.001, P = 0.002, respectively). The current research shows that aged people's exosomes can increase BAX/ BCL-2 ratio in umbilical cord blood-derived HSCs compared to control and young groups.

The purpose of this study was to investigate the long-term effects of chemoradiotherapy and transplantation on the temporomandibular joint (TMJ) and dental status in leukemia and stem cell transplantation (SCT) patients. The study included 44 patients and 22 controls. Participants were categorized into three groups: patients with leukemia in Group-1 (n = 22), patients with SCT in Group-2 (n = 22), and controls in Group-3 (n = 22). All patients were evaluated using the Diagnostic Criteria for TMJ Disorders (TMD), as well as clinical and radiographic assessments. TMD was found in 19 (86%) of the 22 patients in Group-1, 12 (54%) of the 22 patients in Group-2, and 4 (18%) of the 22 controls. The brushing habit was significantly lower in Group-2 than in other Groups (p < 0.05). Group-3 had significantly higher mean values for painless, maximum assisted, and unassisted mouth opening than the other Groups (p < 0.05). The rate of click and crepitation sounds was significantly higher in Group-1 and Group-2 than in Group-3 (p < 0.05). The rate of nondental pain was significantly higher in Group-1 than in other Groups (p < 0.05). The rate of disc displacement with a reduction in both TMJ was significantly higher in Group-1 than in Group-3 (p < 0.05). Radiological studies revealed flattening in at least one condyle in 9 (20%) of both Group-1 and Group-2 patients. Flattening of both condyles and thinning of the mandibular cortex due to osteoporosis were found in 2 (9%) of Group-2. Our data suggest that screening for TMD after chemoradiotherapy and SCT may be beneficial for pediatric leukemia.

Abstract

The objective of this study was to prepare universal plasma by mixing Group A and Group B plasma with normal saline in varying proportions. This prospective in vitro study involved mixing blood group A and B plasma in ratios of 1:1, 3:1, 1:3, and with normal saline in ratios of 1:1:1, 2:2:1, and 1:1:2. The titration of IgG and IgM levels of anti-A and anti-B antibodies, as well as fibrinogen and factor VIII levels, were performed. The titers of anti-A and anti-B antibodies of both IgG and IgM types were found to have significantly decreased in all ratios compared to the control sample. Coagulation factors were found to be higher than the allowable limit when simple plasma mixing ratios (1:1, 3:1, and 1:3) were used, while they significantly decreased upon dilution with normal saline in 1:1:1 and 1:1:2 ratios. In conclusion, the mixing of A and B blood group plasma at a fixed ratio may be a promising strategy for the preparation of universal plasma with a low titre of haemolytic antibodies, while maintaining an adequate amount of coagulation factors.

Thrombotic thrombocytopenic purpura (TTP) is a microangiopathic hemolytic anemia (MAHA) resulting from severe deficiency of ADAMTS13. TTP is an acute medical emergency which requires early treatment with therapeutic plasma exchange. With the early use of Rituximab along with PLEX, early response is achieved and relapse rate has gone down. There is lack of published data from India regarding treatment and outcome of TTP. We retrospectively analyzed our data of 21 patients of TTP including 4 patients who had TA-TMA. TTP patients were treated with TPE, pulse methylprednisolone and rituximab. After a median follow up of 57.5 months overall survival in TTP patients was 82.3% in our study and one patient relapsed twice but again responded to same treatment. Relapse free survival was 92.8%. The mortality rate in our study in TTP patients was (3/17) 17.6%. The total response rate was 82.3% (14/17). Out of 4 patients of TA-TMA, Only 33.3% patients responded to plasma exchange in TA-TMA while two patients died (2/4) 50%. Immediate TPE and early rituximab are associated with improved survival in TTP patients, however TA-TMA still remains a significant challenge for transplant physicians and more research is needed in guiding the therapy.

To support the evidence of plasma exchange’s ability to rapidly lower serum TG levels and provide upcoming research opportunities for evaluating the long-term effects of this treatment, we present the case of a 35-year-old female who was admitted for Hypertriglyceridemia-induced Pancreatitis (HTGP). She underwent Therapeutic Plasma Exchange (TPE) using Spectra Optia Apheresis System on an emergency basis. The patient had a remarkable reduction of serum Triglycerides (TG) from 3953 to 291 mg/dl, which was life saving. On subsequent follow-up the serum TG levels remained constant post-TPE with conservative treatment only. Therapeutic plasma exchange deserves an upgrade in ASFA categorization for the indication in Hypertriglyceridemia induced Pancreatitis.

Introduction

Ensuring optimal blood transfusion practices relies on a robust expertise base that is indispensable across various professional fields. Recognizing this imperative, the current study aims to assess the knowledge levels of healthcare personnel and enhance transfusion quality through targeted continuing training initiatives.

Methods

The preliminary survey was based on an anonymous questionnaire and we used correct response rate (CRR) as the main parameter evaluating the baseline level of knowledge. Then blood transfusion education sessions which focused on transfusion shortcomings were carried out. Finally, we assessed the impact of this training on the baseline education.

Results

From the total of 789 questionnaires distributed, we garnered 331 responses 23 from healthcare staff. The overall CRR for questions related to transfusion procedure knowledge was 33%. Notably, the per-transfusion step exhibited the highest control with CRR of 55% while noticeable gaps were observed in the pre-transfusion (CRR = 22%) and post-transfusion (CRR = 13%) phases. Profession wise variations in CRR were evident, with nurses recording the lowest percentage (CRR = 29%) compared to physicians (CRR = 39%) and technicians (CRR = 34%). Substantial differences were observed in the interpretation of Ultimate Control in the Patient's Bed (UCPB) among professions, especially affecting ABO identity, compatibility, and incompatibility cases. Following the blood transfusion training, attended by 105 participants, only 99 participants responded to the questionnaire post-training, expressing high satisfaction with the covered modules (80%). The knowledge enhancement encompassed all transfusion phases and the interpretation of clinical cases, notably ABO compatibility. Overall, there was a significant improvement in CRR from 33 to 53% (p < 0.001).

Conclusion

This study demonstrates that the evaluation of knowledge should be carried out on a continuous manner in order to detect gaps in the professional sector and to ensure the effectiveness of training through well-targeted educational programs.

ABO (ABH) antigen expression on red cell antigens and secretion of ABH substances in body fluids are governed by different genes. The presence or absence of the Secretor gene is the basis of secretor status positivity and negativity, respectively. Determination of the secretor status has an essential role in the medical field. It was a prospective observational study to determine the association of secretor and nonsecretor status with Lewis phenotyping among voluntary blood donors. It was conducted from Jan 2020 to December 2021 at the Department of Transfusion Medicine in a tertiary care hospital in South India. Among 318 donors, secretors were 229 (72%), and nonsecretors were 89 (28%). The Lewis phenotype was consistent with secretor status, i.e., All Le (a-b +) were secretors accounting for 213 (66.9%), and All Le(a + b-) were nonsecretors accounting for 80(25.1%)donors. In the Le(a-b-) phenotype, 16(5.0%) were secretors with Se positivity but defective Lewis expression, and 9(2.8%) were nonsecretors with sese. Detection of Lewis phenotype indirectly reflects the blood group secretor status. Hence, in case of discrepancies in ABO blood groups, Bombay and Para Bombay groups, testing for Le(b) confirmation will be useful.