Indian Journal of Hematology and Blood Transfusion最新文献

Prevention of birth of thalassemia major children by identification of risk couples and prenatal diagnosis has been recommended as a realistic and cost effective method for control of thalassemia. We present our experience of antenatal thalassemia screening and prenatal diagnosis (PND) in a tertiary care teaching hospital. All antenatal women presenting to the antenatal clinic over 6 years were counseled for beta thalassemia screening. If the lady was detected heterozygous for thalassemia/hemoglobinopathy, partner screening was advised. If the husband was also detected to be heterozygous, the risk couple was offered prenatal diagnosis by chorionic villus tissue DNA analysis. A total of 5392 antenatal women were counseled for beta thalassemia screening, with compliance in 4376 (81.1%) cases. Beta Thalassemia heterozygosity was detected in 147(3.4%) cases, borderline HbA2 in 75(1.7%) and other hemoglobin variants in 91(2.1%). Partner screening was advised in 313 (7.1%) affected antenatal women, with non-compliance in 33.8% cases. Of 27 risk couples identified, prenatal diagnosis was done in 19 couples, detecting 3 affected fetuses. In 8 couples, PND could not be done because of late gestation, financial constraints, lost follow up, failed CVS tissue aspiration and miscarriage prior to CVS tissue biopsy. Late presentation to the antenatal clinic, non-compliance to screening advice and financial constraints could be the factors impeding the thalassemia control program. This emphasizes on the need for community level awareness and inclusion of Thalassemia screening and prenatal diagnosis in the healthcare system.

To study the prevalence of pulmonary arterial hypertension (PAH) in individuals with sickle cell disease (SCD) and its relationship with serological markers. Data of ninety-two SCD patients who visited the Department of Clinical Haematology between 2020 and 2021 was retrieved through the hospital record system. These patients underwent laboratory testing, including a clinical evaluation was done at baseline. They underwent Doppler echocardiography to determine the maximum tricuspid regurgitation jet velocity. Among 92 patients, 43 were men and 49 were female, with the mean age being 29.9 ± 8.8 years. Using Doppler echocardiography, their pulmonary artery systolic pressure was determined. Pulmonary arterial hypertension was found in 29 out of 92 patients (31.5%). The prevalence of PAH was 20.9% in males and 40.8% in women. A significant association was shown with females (p = 0.041.) There was a positive correlation with hemolytic markers, including reticulocyte count (r = 0.212, p < 0.05), lactate dehydrogenase (r = 0.322, p < 0.01 with tricuspid regurgitation velocity (TRvmax) (r = 0.322, p < 0.01) along with NT-ProBNP (r = 0.310, p < 0.01). The maximal tricuspid regurgitation velocity and haemoglobin concentration had a negative correlation. (r = -0.340, p < 0.01). In resource-limited settings, NT Pro BNP and transthoracic echocardiography can be used as screening tools for pulmonary hypertension in SCD.

The incidence of deep vein thrombosis (DVT) is increasing with aging, which needs a screening and monitoring biomarker. This study focused on the significance of aging- and angiogenesis-related lncRNA RAMP2-AS1 (RAMP2-AS1) aiming to identify a promising biomarker for the incidence of DVT. Serum samples were collected from 63 healthy individuals and 98 patients with DVT. The serum RAMP2-AS1 level was analyzed by PCR and its significance in DVT detection and development prediction was evaluated by ROC and multivariate Cox regression analysis. The regulatory effect of RAMP2-AS1 on endothelial progenitor cells (EPCs) was evaluated by CCK8 and transwell assays. RAMP2-AS1 was significantly downregulated in patients with DVT, which could discriminate patients with DVT from healthy individuals with relatively high sensitivity and specificity. The downregulation of RAMP2-AS1 could predict poor outcomes and was associated with activities of daily living (ADL), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), and monocyte to high-density lipoprotein cholesterol ratio (MHR) of patients with DVT. RAMP2-AS1 was identified as an independent prognostic factor of DVT by Cox regression analysis. In EPCs, overexpressing RAMP2-AS1 significantly suppressed cell proliferation, migration, and invasion. Downregulated serum RAMP2-AS1 could predict the incidence and progression of DVT. RAMP2-AS1 inhibited EPCs growth and motility, which provides a target for thrombolytic therapy. RAMP2-AS1 level could be included in the risk assessment model of DVT.

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.