Pub Date : 2021-08-31DOI: 10.17945/kjbt.2021.32.2.91
Taeeun Kim, Yunju Park, Leeseul Shin, Yu Soek Jung, M. Youn, Yeongbin Kim
Background: There have been some domestic and overseas cases of anti-D alloimmunization caused by the transfusion of serologically D-negative blood. However, it is difficult to distinguish between true D-negative and DEL variants using conventional serologic typing. Therefore, we established the RHD genotyping algorithm for the detection of DEL variants and applied this algorithm to serologic D negative donors who voluntarily consented to testing. Methods: From September 2016 to December 2020, 216 RhD negative donors who were C ＋ and/or E+ in previous serologic typing were recruited. The screening test was PCR amplification of the RHD exons 4, 7, 10, and a promotor. Based on the results of PCR screening, true D-negative samples and RHD variants (including DEL) were discriminated. When the result was a RHD variant, exon 9 was sequenced to identify the nucleotide changes. Full sequencing was performed if no mutations were detected at exon 9. Results: Among the 216 participants, 39 cases with the C − E − c ＋ e ＋ phenotypes that did not meet the recruitment criteria were excluded from data analysis. Among the remaining 177 samples, 68 cases (38.4%) were RHD total deletions, 35 cases (19.8%) were RHD -CE-D hybrids, and 74 cases (41.8%) were RHD variants. Among the cases of RHD variants, 73 cases (98.6%) had c.1227G ＞ A substitutions and were confirmed as Asian-type DEL. Conclusion: Seventy-four cases of serologic D negative donors were reclassified as RHD variants by RHD genotyping. This is believed to have contributed to the improvement of transfusion safety by lowering the risk of anti-D alloimmunization in D-negative patients. (Korean J Blood Transfus 2021;32:91-101)
背景:国内外已有因输血血清学上d阴性血引起的抗d异体免疫的病例。然而，使用传统的血清学分型很难区分真正的d阴性和DEL变异。因此，我们建立了检测DEL变异的RHD基因分型算法，并将该算法应用于自愿接受检测的血清学D阴性献血者。方法:2016年9月至2020年12月，招募216名既往血清学分型为C +和/或E+的RhD阴性献血者。筛选试验为RHD外显子4、7、10和启动子的PCR扩增。根据PCR筛选结果，区分真d阴性样本和RHD变异(包括DEL)。当结果是RHD变异时，对外显子9进行测序以确定核苷酸变化。如果外显子9未检测到突变，则进行全测序。结果:在216名参与者中，39例不符合招募标准的C−E−C + E +表型被排除在数据分析之外。其余177例中，RHD全缺失68例(38.4%)，RHD -CE-D杂交35例(19.8%)，RHD变异体74例(41.8%)。RHD变异中，c.1227G > A置换73例(98.6%)，确认为亚洲型DEL。结论:74例血清学D阴性供者通过RHD基因分型重新分类为RHD变异。这被认为有助于通过降低d阴性患者抗d异体免疫的风险来改善输血安全性。(韩国输血杂志2021;32:91-101)
{"title":"The Experience of RHD Genotyping in D-negative Blood Donors","authors":"Taeeun Kim, Yunju Park, Leeseul Shin, Yu Soek Jung, M. Youn, Yeongbin Kim","doi":"10.17945/kjbt.2021.32.2.91","DOIUrl":"https://doi.org/10.17945/kjbt.2021.32.2.91","url":null,"abstract":"Background: There have been some domestic and overseas cases of anti-D alloimmunization caused by the transfusion of serologically D-negative blood. However, it is difficult to distinguish between true D-negative and DEL variants using conventional serologic typing. Therefore, we established the RHD genotyping algorithm for the detection of DEL variants and applied this algorithm to serologic D negative donors who voluntarily consented to testing. Methods: From September 2016 to December 2020, 216 RhD negative donors who were C ＋ and/or E+ in previous serologic typing were recruited. The screening test was PCR amplification of the RHD exons 4, 7, 10, and a promotor. Based on the results of PCR screening, true D-negative samples and RHD variants (including DEL) were discriminated. When the result was a RHD variant, exon 9 was sequenced to identify the nucleotide changes. Full sequencing was performed if no mutations were detected at exon 9. Results: Among the 216 participants, 39 cases with the C − E − c ＋ e ＋ phenotypes that did not meet the recruitment criteria were excluded from data analysis. Among the remaining 177 samples, 68 cases (38.4%) were RHD total deletions, 35 cases (19.8%) were RHD -CE-D hybrids, and 74 cases (41.8%) were RHD variants. Among the cases of RHD variants, 73 cases (98.6%) had c.1227G ＞ A substitutions and were confirmed as Asian-type DEL. Conclusion: Seventy-four cases of serologic D negative donors were reclassified as RHD variants by RHD genotyping. This is believed to have contributed to the improvement of transfusion safety by lowering the risk of anti-D alloimmunization in D-negative patients. (Korean J Blood Transfus 2021;32:91-101)","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122683960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-31DOI: 10.17945/kjbt.2021.32.2.129
Hyun Ji Lee, Kyung-Hwa Shin, S. Jo, Hyung-Hoi Kim
To increase the success rate of heart and lung transplantation, appropriate transfusion and desensitization treatment should be performed. In each hospital, transfusion should be performed according to the patient and hospital situation and monitored to ensure that an appropriate amount of transfusion is achieved is necessary. If HLA desensitization treatment is performed using plasmapheresis and immunosuppressants, the incidence of rejection and complications after transplantation can be reduced. For desensitization treatment that considers individual patient characteristics, close cooperation between clinical medical staff, blood bank personnel, and medical staff will be required. (Korean J Blood Transfus 2021;32:129-131)
{"title":"Transfusion and Plasmapheresis in Heart and Lung Transplantation in Korea","authors":"Hyun Ji Lee, Kyung-Hwa Shin, S. Jo, Hyung-Hoi Kim","doi":"10.17945/kjbt.2021.32.2.129","DOIUrl":"https://doi.org/10.17945/kjbt.2021.32.2.129","url":null,"abstract":"To increase the success rate of heart and lung transplantation, appropriate transfusion and desensitization treatment should be performed. In each hospital, transfusion should be performed according to the patient and hospital situation and monitored to ensure that an appropriate amount of transfusion is achieved is necessary. If HLA desensitization treatment is performed using plasmapheresis and immunosuppressants, the incidence of rejection and complications after transplantation can be reduced. For desensitization treatment that considers individual patient characteristics, close cooperation between clinical medical staff, blood bank personnel, and medical staff will be required. (Korean J Blood Transfus 2021;32:129-131)","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114781478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-31DOI: 10.17945/kjbt.2021.32.2.83
Eun-Hyung Yoo, A-Jin Lee, Sang-Gyung Kim, C. Jeon
Background: Severe fever with thrombocytopenia syndrome (SFTS) is a novel infection caused by the tick-borne SFTS virus. More than 200 patients are reported every year in Korea, but there is no established treatment. In patients with SFTS, therapeutic plasma exchange (TPE) can be applied. Methods: Clinical and laboratory characteristics of patients diagnosed with SFTS who underwent TPE were analyzed. The factors that can differentiate the prognosis between the patients who recovered after TPE and those who died were analyzed. Results: Ten patients were diagnosed with SFTS and treated with TPE. The mean age was 70.8 (49–85) years, with three men and seven females. The laboratory findings showed a decrease in white blood cell (WBC) count, platelet count, and serum albumin and an increase in AST, ALT, LDH, and CK levels. Patients performed an average of three (2∼4) TPE procedures at intervals of 1∼2 days, three of whom died. Compared to the results at admission, the WBC counts increased after TPE, and the platelet counts remained unchanged. The AST, LDH, and CK levels decreased by 2∼6 fold in the recovered patients and increased in those who died. Among them, the change in LDH was statistically significant between the two groups (P=0.0227). Conclusion: TPE has been used as an adjuvant treatment in SFTS patients who do not have a definitive treatment to date. Additional studies, including small-scale studies such as this study, will be needed to establish the timing, interval, and predictive factors of the effect of TPE. (Korean J Blood Transfus 2021;32:83-90)
{"title":"Therapeutic Plasma Exchange in Patients with Severe Fever with Thrombocytopenia Syndrome: A Single Institution Experience","authors":"Eun-Hyung Yoo, A-Jin Lee, Sang-Gyung Kim, C. Jeon","doi":"10.17945/kjbt.2021.32.2.83","DOIUrl":"https://doi.org/10.17945/kjbt.2021.32.2.83","url":null,"abstract":"Background: Severe fever with thrombocytopenia syndrome (SFTS) is a novel infection caused by the tick-borne SFTS virus. More than 200 patients are reported every year in Korea, but there is no established treatment. In patients with SFTS, therapeutic plasma exchange (TPE) can be applied. Methods: Clinical and laboratory characteristics of patients diagnosed with SFTS who underwent TPE were analyzed. The factors that can differentiate the prognosis between the patients who recovered after TPE and those who died were analyzed. Results: Ten patients were diagnosed with SFTS and treated with TPE. The mean age was 70.8 (49–85) years, with three men and seven females. The laboratory findings showed a decrease in white blood cell (WBC) count, platelet count, and serum albumin and an increase in AST, ALT, LDH, and CK levels. Patients performed an average of three (2∼4) TPE procedures at intervals of 1∼2 days, three of whom died. Compared to the results at admission, the WBC counts increased after TPE, and the platelet counts remained unchanged. The AST, LDH, and CK levels decreased by 2∼6 fold in the recovered patients and increased in those who died. Among them, the change in LDH was statistically significant between the two groups (P=0.0227). Conclusion: TPE has been used as an adjuvant treatment in SFTS patients who do not have a definitive treatment to date. Additional studies, including small-scale studies such as this study, will be needed to establish the timing, interval, and predictive factors of the effect of TPE. (Korean J Blood Transfus 2021;32:83-90)","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"226 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134634703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-30DOI: 10.17945/KJBT.2021.32.1.22
Jung-ah Kim, J. Shin, Do Lee Lee, W. Shin, Jieun Kim, H. I. Bang
blood bank, if the Ab screening test results are positive in the pretransfusion test, an Ab identification test and polyspecific direct antiglobulin test (DAT) are performed. IgG and C3 monospecific DATs are also performed if the polyspecific DAT is positive. To perform additional tests, clinical technologists used to communicate with the clinical department by telephone, and then the clinical doctor issued the orders. There could be problems with this process, such as clerical errors and reduced work efficiency. Therefore, this study developed the secondary order program to improve the work efficiency of the blood bank. Methods: The secondary order program that allows the laboratory medicine doctors to issue additional test orders, print out barcodes in blood bank, and immediately report the results to the EMR (Electronic Medical Record) was developed. Before (Jul 2018 ∼ Jun 2019) and after (Jul 2019 ∼ Jun 2020) applying the program to inpatients, the number of telephone calls, Ab screening tests, Ab identification tests, polyspecific DAT, and monospecific DAT were compared to evaluate the effectiveness of the program. Results: After applying the program, 515 calls per year (average 43 calls per month) were reduced. Before the program, the results of 68 Ab screening tests and 16 polyspecific DATs were not reported on EMR, but no case was missed after the program. Conclusion: Through the secondary order program, the work efficiency of the blood bank was improved. It is expected that expanding this program to other blood bank tests will help implement tests faster and make them more systematic. (Korean J Blood Transfus 2021;32:22-27)
{"title":"Development of a Secondary Order Program for Pretransfusion Tests to Improve the Work Efficiency of Blood Bank","authors":"Jung-ah Kim, J. Shin, Do Lee Lee, W. Shin, Jieun Kim, H. I. Bang","doi":"10.17945/KJBT.2021.32.1.22","DOIUrl":"https://doi.org/10.17945/KJBT.2021.32.1.22","url":null,"abstract":"blood bank, if the Ab screening test results are positive in the pretransfusion test, an Ab identification test and polyspecific direct antiglobulin test (DAT) are performed. IgG and C3 monospecific DATs are also performed if the polyspecific DAT is positive. To perform additional tests, clinical technologists used to communicate with the clinical department by telephone, and then the clinical doctor issued the orders. There could be problems with this process, such as clerical errors and reduced work efficiency. Therefore, this study developed the secondary order program to improve the work efficiency of the blood bank. Methods: The secondary order program that allows the laboratory medicine doctors to issue additional test orders, print out barcodes in blood bank, and immediately report the results to the EMR (Electronic Medical Record) was developed. Before (Jul 2018 ∼ Jun 2019) and after (Jul 2019 ∼ Jun 2020) applying the program to inpatients, the number of telephone calls, Ab screening tests, Ab identification tests, polyspecific DAT, and monospecific DAT were compared to evaluate the effectiveness of the program. Results: After applying the program, 515 calls per year (average 43 calls per month) were reduced. Before the program, the results of 68 Ab screening tests and 16 polyspecific DATs were not reported on EMR, but no case was missed after the program. Conclusion: Through the secondary order program, the work efficiency of the blood bank was improved. It is expected that expanding this program to other blood bank tests will help implement tests faster and make them more systematic. (Korean J Blood Transfus 2021;32:22-27)","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131512144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-30DOI: 10.17945/KJBT.2021.32.1.43
Jungwon Kang, J. Kang, Dae Ho Ko, M. Youn, So‐Yong Kwon
Analysis of HCV genotypes can help identify infection routes and the development of treatment methods. However, in some samples with a low titer of HCV RNA, it is difficult to analyze their genotypes. In our previous study about HCV genotyping, we could not identify 12 cases among the 175 HCV NAT reactive samples due to their low titer. In this study, we adopted three different kinds of virus concentration methods to identify the genotypes of the 12 unidentified cases and compared their efficacy. The three virus concentration methods were automatic nucleic acid extraction, polyethyleneimine-magnetic bead-based extraction, and sucrose cushion ultracentrifugation. After virus concentration using every three methods, we analyzed HCV RNA genotypes using the concentrated sample of the best efficacy. Among the 12 cases, six were identified as 1b, four as mixed types, and two were unidentified. Here we could validate that the sample concentration method is useful to identify the HCV genotypes, especially in samples with low HCV RNA titers. Furthermore, considering the convenience, high efficacy, and time-saving, automatic nucleic acid extraction is considered the most useful concentration method for samples with titer lower than 50 IU/mL. (Korean J Blood Transfus 2021;32:43-48)
{"title":"Analysis of HCV Genotype with Low Titer of HCV RNA Using the Methods of Concentration","authors":"Jungwon Kang, J. Kang, Dae Ho Ko, M. Youn, So‐Yong Kwon","doi":"10.17945/KJBT.2021.32.1.43","DOIUrl":"https://doi.org/10.17945/KJBT.2021.32.1.43","url":null,"abstract":"Analysis of HCV genotypes can help identify infection routes and the development of treatment methods. However, in some samples with a low titer of HCV RNA, it is difficult to analyze their genotypes. In our previous study about HCV genotyping, we could not identify 12 cases among the 175 HCV NAT reactive samples due to their low titer. In this study, we adopted three different kinds of virus concentration methods to identify the genotypes of the 12 unidentified cases and compared their efficacy. The three virus concentration methods were automatic nucleic acid extraction, polyethyleneimine-magnetic bead-based extraction, and sucrose cushion ultracentrifugation. After virus concentration using every three methods, we analyzed HCV RNA genotypes using the concentrated sample of the best efficacy. Among the 12 cases, six were identified as 1b, four as mixed types, and two were unidentified. Here we could validate that the sample concentration method is useful to identify the HCV genotypes, especially in samples with low HCV RNA titers. Furthermore, considering the convenience, high efficacy, and time-saving, automatic nucleic acid extraction is considered the most useful concentration method for samples with titer lower than 50 IU/mL. (Korean J Blood Transfus 2021;32:43-48)","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131507909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-30DOI: 10.17945/KJBT.2021.32.1.11
Jaehyun Kim
Normal hemostasis is achieved by the concerted interactions of vascular endothelial cells, platelets, and plasma coagulation factors. The blood coagulation mechanism involves the regulated sequence of proteolytic activation of a series of blood coagulation zymogen factors. Some of these blood coagulation factors, either purified from human plasma or produced by recombinant DNA technologies, are used to treat patients with congenital or acquired deficiencies in coagulation factors. Furthermore, blood coagulation products are used for perioperative coagulation management and toical hemostatic agents to help control bleeding during surgery. Thus, the coagulant blood products have great medical importance to treat life-threatening bleeding disorders and serious medical conditions. This review provides an overview and summarizes the clinical use of coagulant blood products. (Korean J Blood Transfus 2021;32:11-21)
{"title":"Blood Coagulation Products and Other Hemostatic Agents","authors":"Jaehyun Kim","doi":"10.17945/KJBT.2021.32.1.11","DOIUrl":"https://doi.org/10.17945/KJBT.2021.32.1.11","url":null,"abstract":"Normal hemostasis is achieved by the concerted interactions of vascular endothelial cells, platelets, and plasma coagulation factors. The blood coagulation mechanism involves the regulated sequence of proteolytic activation of a series of blood coagulation zymogen factors. Some of these blood coagulation factors, either purified from human plasma or produced by recombinant DNA technologies, are used to treat patients with congenital or acquired deficiencies in coagulation factors. Furthermore, blood coagulation products are used for perioperative coagulation management and toical hemostatic agents to help control bleeding during surgery. Thus, the coagulant blood products have great medical importance to treat life-threatening bleeding disorders and serious medical conditions. This review provides an overview and summarizes the clinical use of coagulant blood products. (Korean J Blood Transfus 2021;32:11-21)","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115458379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-30DOI: 10.17945/KJBT.2021.32.1.1
Yeongbin Kim, A. Lim, Tae Eun Kim, Chul Ho Jung, M. Park, Jiyeong Seon, K. Youn, Anissa Lee, M. Youn
Yeongbin Kim, M.D., A Hyun Lim, M.S., Tae Eun Kim, M.S., Chul Ho Jung, M.T., Minhui Park, M.T., Jiyeong Seon, M.T., Kyoung Won Youn, M.S., An Gyo Lee, M.T., Miae Youn, M.D. Blood Transfusion Research Institute, Korean Red Cross, Wonju; Plasma Fractionation Center, Korean Red Cross, Eumseong; Chungbuk Blood Center, Korean Red Cross, Cheongju; Daejeon Sejong Chungnam Blood Center, Korean Red Cross, Daejeon, Korea
{"title":"Current Status of Korean Red Cross HLA-Matched Platelet Donor Registry","authors":"Yeongbin Kim, A. Lim, Tae Eun Kim, Chul Ho Jung, M. Park, Jiyeong Seon, K. Youn, Anissa Lee, M. Youn","doi":"10.17945/KJBT.2021.32.1.1","DOIUrl":"https://doi.org/10.17945/KJBT.2021.32.1.1","url":null,"abstract":"Yeongbin Kim, M.D., A Hyun Lim, M.S., Tae Eun Kim, M.S., Chul Ho Jung, M.T., Minhui Park, M.T., Jiyeong Seon, M.T., Kyoung Won Youn, M.S., An Gyo Lee, M.T., Miae Youn, M.D. Blood Transfusion Research Institute, Korean Red Cross, Wonju; Plasma Fractionation Center, Korean Red Cross, Eumseong; Chungbuk Blood Center, Korean Red Cross, Cheongju; Daejeon Sejong Chungnam Blood Center, Korean Red Cross, Daejeon, Korea","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"51 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120854745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-30DOI: 10.17945/KJBT.2021.32.1.35
H. Park, K. Shin, B. Son
Background: Blood transfusion is frequently performed as a supportive therapy during the diagnosis and chemotherapy of acute myeloid leukemia (AML). This study examined the frequency of blood transfusion and analyzed the correlation with the treatment response during induction therapy in patients with AML. Methods: From January 2018 to December 2020, blood transfusion information was collected from 23 patients diagnosed with AML during induction therapy. The frequency and volumes of blood transfusions according to the treatment response were collected and analyzed with the overall survival retrospectively. Results: The blood transfusion was performed in all patients with AML during induction therapy. The transfusion frequency and volumes were a median of five (1∼13) times and nine (2∼27) units for red blood cells, respectively. In the platelets, the median frequency was seven (2∼21) times, and the transfusion volumes were 42 (12∼128) units. At the time of the treatment response evaluation, the transfusion dependence was 0% in morphological complete remission and 20% in the morphological leukemic-free state for both RBC and platelets, and 78% for RBC and 67% for platelets in treatment failure. Although not statistically significant, transfusion independence for more than eight weeks after induction therapy showed a better overall survival (P=0.312). Conclusion: When the treatment response was good, the dependence on blood transfusion decreased. The transfusion frequency is expected to help predict the patient's treatment response and prognosis along with the peripheral blood counts. (Korean J Blood Transfus 2021;32:35-42)
{"title":"Transfusion Dependency in Patients with Acute Myeloid Leukemia during Induction Chemotherapy","authors":"H. Park, K. Shin, B. Son","doi":"10.17945/KJBT.2021.32.1.35","DOIUrl":"https://doi.org/10.17945/KJBT.2021.32.1.35","url":null,"abstract":"Background: Blood transfusion is frequently performed as a supportive therapy during the diagnosis and chemotherapy of acute myeloid leukemia (AML). This study examined the frequency of blood transfusion and analyzed the correlation with the treatment response during induction therapy in patients with AML. Methods: From January 2018 to December 2020, blood transfusion information was collected from 23 patients diagnosed with AML during induction therapy. The frequency and volumes of blood transfusions according to the treatment response were collected and analyzed with the overall survival retrospectively. Results: The blood transfusion was performed in all patients with AML during induction therapy. The transfusion frequency and volumes were a median of five (1∼13) times and nine (2∼27) units for red blood cells, respectively. In the platelets, the median frequency was seven (2∼21) times, and the transfusion volumes were 42 (12∼128) units. At the time of the treatment response evaluation, the transfusion dependence was 0% in morphological complete remission and 20% in the morphological leukemic-free state for both RBC and platelets, and 78% for RBC and 67% for platelets in treatment failure. Although not statistically significant, transfusion independence for more than eight weeks after induction therapy showed a better overall survival (P=0.312). Conclusion: When the treatment response was good, the dependence on blood transfusion decreased. The transfusion frequency is expected to help predict the patient's treatment response and prognosis along with the peripheral blood counts. (Korean J Blood Transfus 2021;32:35-42)","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133527966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-30DOI: 10.17945/KJBT.2021.32.1.49
So Mi Kim, S. H. Kim
A 73-year-old male patient undergoing hemodialysis showed an abnormal liver function test after the transfusion of two units of red blood cell (RBC). The results of the pre-transfusion test were negative HBsAg and positive anti-HBs. On the other hand, the results of the post-transfusion test were positive HBsAg and negative anti-HBs. The other test results were positive HBeAg, positive HBV DNA, and positive anti-HBc IgG. It was reported as a blood transfusion reaction in doubt of a transfusion-transmitted hepatitis B virus (HBV) infection. An examination of the blood information management system data, health insurance data, medical records, and test of storage samples showed that it was not a blood transfusion reaction. It was believed to be an occult HBV infection in an immunosuppressive patient receiving hemodialysis. Hemodialysis patients have a high prevalence of hepatitis B and C, and are classified as a risk group of occult infections. This raises the need for HBV vaccination in dialysis patients. Virus infections can be activated in dialysis patients due to the patient's immune system and other causes. If a blood transfusion is performed during this period, attention is needed because it can be mistaken for viral transmission from blood products. (Korean J Blood Transfus 2021;32:49-54)
{"title":"Case of Suspected Occult Hepatitis B Virus Infection Mistaken for a Transfusion-Transmitted Infection in a Hemodialysis Patient","authors":"So Mi Kim, S. H. Kim","doi":"10.17945/KJBT.2021.32.1.49","DOIUrl":"https://doi.org/10.17945/KJBT.2021.32.1.49","url":null,"abstract":"A 73-year-old male patient undergoing hemodialysis showed an abnormal liver function test after the transfusion of two units of red blood cell (RBC). The results of the pre-transfusion test were negative HBsAg and positive anti-HBs. On the other hand, the results of the post-transfusion test were positive HBsAg and negative anti-HBs. The other test results were positive HBeAg, positive HBV DNA, and positive anti-HBc IgG. It was reported as a blood transfusion reaction in doubt of a transfusion-transmitted hepatitis B virus (HBV) infection. An examination of the blood information management system data, health insurance data, medical records, and test of storage samples showed that it was not a blood transfusion reaction. It was believed to be an occult HBV infection in an immunosuppressive patient receiving hemodialysis. Hemodialysis patients have a high prevalence of hepatitis B and C, and are classified as a risk group of occult infections. This raises the need for HBV vaccination in dialysis patients. Virus infections can be activated in dialysis patients due to the patient's immune system and other causes. If a blood transfusion is performed during this period, attention is needed because it can be mistaken for viral transmission from blood products. (Korean J Blood Transfus 2021;32:49-54)","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123905220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-30DOI: 10.17945/KJBT.2021.32.1.28
W. Kim, Geon Park
Background: DEL is an RhD variant that cannot be detected by routine serologic tests because of the extremely low expression of the RhD antigen. Detecting the common genotypes of RHD 1227G ＞ A and 1222T ＞ C in Korean DEL is important for safe and efficient blood transfusions. Therefore, in this study, a PCR-restriction enzyme fragment polymorphism (RFLP) method was applied to detect RHD 1227G ＞ A and 1222T ＞ C. Methods: DNA extracted from the blood of each segment of 56 units of RhD-negative red blood cell were used. The promoter, exon 7 and exon 9 of RHD , and exon 9 of RHCE were amplified. The PCR products of RHD exon 7, RHD exon 9, and RHCE exon 9 were treated with the restriction enzymes HpyAV and MspI, and the RFLP patterns were observed by electrophoresis. The results of PCR-RFLP of RHD exon 9 were confirmed by PCR-direct sequencing. Results: RHCE exon 9 was amplified in all 56 DNAs. RHD promoters, exon 7, and exon 9 were all amplified in 10 samples, RHD promoter, exon 7, and exon 9 were not amplified in 38 samples, and RHD promoter only was amplified in eight samples. As a result of the RHD exon 9 PCR-RFLP performed on 10 samples with all targets amplified, 10 samples were determined to be 9 samples with 1227G ＞ A and 1 sample with 1222T ＞ C. The PCR-RFLP result and the sequencing result were 100% identical. Conclusion: PCR-RFLP using HpyAV and MspI is a reliable and applicable method for detecting RHD 1227G>A and 1222T ＞ C in serologically RhD negative samples. (Korean J Blood Transfus 2021;32:28-34) binding sites indicate ranges of primer binding sequences according to reference sequences (accession No. RHD NG_007494.1 and RHCE NG_009208.3). Abbreviations: Ta, annealing temperature; P, PCR; R, restriction fragment length polymorphism; S, sequencing.
{"title":"Detection of RHD 1227G>A and 1222T>C Using PCR-Restriction Fragment Length Polymorphism","authors":"W. Kim, Geon Park","doi":"10.17945/KJBT.2021.32.1.28","DOIUrl":"https://doi.org/10.17945/KJBT.2021.32.1.28","url":null,"abstract":"Background: DEL is an RhD variant that cannot be detected by routine serologic tests because of the extremely low expression of the RhD antigen. Detecting the common genotypes of RHD 1227G ＞ A and 1222T ＞ C in Korean DEL is important for safe and efficient blood transfusions. Therefore, in this study, a PCR-restriction enzyme fragment polymorphism (RFLP) method was applied to detect RHD 1227G ＞ A and 1222T ＞ C. Methods: DNA extracted from the blood of each segment of 56 units of RhD-negative red blood cell were used. The promoter, exon 7 and exon 9 of RHD , and exon 9 of RHCE were amplified. The PCR products of RHD exon 7, RHD exon 9, and RHCE exon 9 were treated with the restriction enzymes HpyAV and MspI, and the RFLP patterns were observed by electrophoresis. The results of PCR-RFLP of RHD exon 9 were confirmed by PCR-direct sequencing. Results: RHCE exon 9 was amplified in all 56 DNAs. RHD promoters, exon 7, and exon 9 were all amplified in 10 samples, RHD promoter, exon 7, and exon 9 were not amplified in 38 samples, and RHD promoter only was amplified in eight samples. As a result of the RHD exon 9 PCR-RFLP performed on 10 samples with all targets amplified, 10 samples were determined to be 9 samples with 1227G ＞ A and 1 sample with 1222T ＞ C. The PCR-RFLP result and the sequencing result were 100% identical. Conclusion: PCR-RFLP using HpyAV and MspI is a reliable and applicable method for detecting RHD 1227G>A and 1222T ＞ C in serologically RhD negative samples. (Korean J Blood Transfus 2021;32:28-34) binding sites indicate ranges of primer binding sequences according to reference sequences (accession No. RHD NG_007494.1 and RHCE NG_009208.3). Abbreviations: Ta, annealing temperature; P, PCR; R, restriction fragment length polymorphism; S, sequencing.","PeriodicalId":231122,"journal":{"name":"The Korean Journal of Blood Transfusion","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124459135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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