Pub Date : 2024-07-16DOI: 10.1016/j.tracli.2024.07.002
Pierre Arnautou , Guillaume Garnier , Jean Maillot , Johanna Konopacki , Michel Brachet , Annabelle Bonnin , Jean-Christophe Amabile , Jean-Valère Malfuson
Acute radiation syndrome encompasses a spectrum of pathological manifestations resulting from exposure to high doses of ionizing radiation. This syndrome typically progresses through three stages with a prodromal phase, a latency phase and a critical phase. Each of them varies in intensity and duration depending on the absorbed dose of radiation. Predominantly affecting the bone marrow, skin, and gastrointestinal tract, its clinical implications are profound and multiorgan failure must be considered. Radiation doses below 2 Gray generally result in insignificant clinical consequences, while exposures surpassing 12 Gray exceeds current therapeutic capacities.
Survival outcomes for patients within this therapeutic range depend on their ability to withstand radiation-induced aplasia, compounded by an increased risk of bleeding and infection due to skin, gastrointestinal, and potentially combined radiation injuries.
Assessing the degree of radiation exposure plays a pivotal role in tailoring patient management strategies and is based on a combination of clinical, biological, and physical parameters. Treatment approaches primarily include intensive hematologic support to manage symptomatic manifestations and etiologic treatment is now based on the administration of growth factors.
The role of hematopoietic stem cell transplant (HSCT) will be carefully considered on an individual basis, especially for patients who do not respond following 3 weeks of cytokine therapy.
This review highlights the pathophysiological mechanisms, assessment modalities, and therapeutic interventions crucial for managing acute radiation syndrome aiming to optimize patient outcomes and guide clinical practice.
{"title":"Management of acute radiation syndrome","authors":"Pierre Arnautou , Guillaume Garnier , Jean Maillot , Johanna Konopacki , Michel Brachet , Annabelle Bonnin , Jean-Christophe Amabile , Jean-Valère Malfuson","doi":"10.1016/j.tracli.2024.07.002","DOIUrl":"10.1016/j.tracli.2024.07.002","url":null,"abstract":"<div><div>Acute radiation syndrome encompasses a spectrum of pathological manifestations resulting from exposure to high doses of ionizing radiation. This syndrome typically progresses through three stages with a prodromal phase, a latency phase and a critical phase. Each of them varies in intensity and duration depending on the absorbed dose of radiation. Predominantly affecting the bone marrow, skin, and gastrointestinal tract, its clinical implications are profound and multiorgan failure must be considered. Radiation doses below 2 Gray generally result in insignificant clinical consequences, while exposures surpassing 12 Gray exceeds current therapeutic capacities.</div><div>Survival outcomes for patients within this therapeutic range depend on their ability to withstand radiation-induced aplasia, compounded by an increased risk of bleeding and infection due to skin, gastrointestinal, and potentially combined radiation injuries.</div><div>Assessing the degree of radiation exposure plays a pivotal role in tailoring patient management strategies and is based on a combination of clinical, biological, and physical parameters. Treatment approaches primarily include intensive hematologic support to manage symptomatic manifestations and etiologic treatment is now based on the administration of growth factors.</div><div>The role of hematopoietic stem cell transplant (HSCT) will be carefully considered on an individual basis, especially for patients who do not respond following 3 weeks of cytokine therapy.</div><div>This review highlights the pathophysiological mechanisms, assessment modalities, and therapeutic interventions crucial for managing acute radiation syndrome aiming to optimize patient outcomes and guide clinical practice.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 4","pages":"Pages 253-259"},"PeriodicalIF":1.4,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09DOI: 10.1016/j.tracli.2024.07.001
{"title":"Beyond the Microscope: A memoir of Professor Sudha S. Bhat, an iconic Indian pathologist, and a transfusion medicine specialist","authors":"","doi":"10.1016/j.tracli.2024.07.001","DOIUrl":"10.1016/j.tracli.2024.07.001","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 4","pages":"Pages 192-193"},"PeriodicalIF":1.4,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-27DOI: 10.1016/j.tracli.2024.06.009
{"title":"WBDD, VBD and India: It’s time for Red revolution","authors":"","doi":"10.1016/j.tracli.2024.06.009","DOIUrl":"10.1016/j.tracli.2024.06.009","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 4","pages":"Pages 270-271"},"PeriodicalIF":1.4,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-22DOI: 10.1016/j.tracli.2024.06.005
{"title":"Hepatitis A and leptospirosis dual infection-induced Fulminant Hepatic Failure successfully treated with standard volume Therapeutic Plasma Exchange","authors":"","doi":"10.1016/j.tracli.2024.06.005","DOIUrl":"10.1016/j.tracli.2024.06.005","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 4","pages":"Pages 265-266"},"PeriodicalIF":1.4,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-21DOI: 10.1016/j.tracli.2024.06.007
Background and Objectives
Hemolytic transfusion reactions (HTRs) pose significant risks in transfused patients, with anti-A and anti-B antibodies in donor plasma being potential contributing factors. Despite advancements in component preparation, HTRs remain a concern, particularly with apheresis-derived platelets. This study aimed to determine the prevalence of high anti-A and anti-B titers among A, B, and O blood group donors and to explore factors associated with high titers.
Materials and Methods
A cross-sectional observational study was conducted over 18 months, enrolling 978 participants from a tertiary care teaching hospital in Western India. Anti-A and anti-B titers were determined using the Conventional Tube Technique (CTT). Statistical analysis assessed correlations between high titers and demographic factors.
Results
The majority of participants were young males (98.8%). Prevalence of high titers for IgM anti-A was 12.2% and IgG anti-A was 2.5%. For anti-B, IgM titers were 2.3% and IgG titers were 0.2%. The prevalence of dangerous O was found to be 14.1%, while 3.52% and 10.5% of A and B blood group donors were found to have high titers, respectively. Factors associated with high titers included female gender, vegetarian diet, age <30 years, and O blood group.
Conclusion
The study sheds additional light and provides supplementary information regarding the prevalence and correlation of high anti-A and anti-B titers among O, A and B blood donors. Understanding these factors is crucial for optimizing transfusion safety protocols, including selective screening of platelet units and tailored transfusion strategies based on donor characteristics.
背景和目的:溶血性输血反应(HTR)对输血患者构成重大风险,供体血浆中的抗 A 和抗 B 抗体是潜在的诱因。尽管成分制备技术不断进步,但溶血性输血反应仍是一个令人担忧的问题,尤其是无细胞血浆来源的血小板。本研究旨在确定高抗A和抗B滴度在A、B和O型血献血者中的流行率,并探讨与高滴度相关的因素:这项横断面观察研究历时 18 个月,从印度西部一家三级医疗教学医院招募了 978 名参与者。采用传统试管技术(CTT)测定抗 A 和抗 B 滴度。统计分析评估了高滴度与人口统计学因素之间的相关性:结果:大多数参与者为年轻男性(98.8%)。高滴度 IgM 抗 A 为 12.2%,IgG 抗 A 为 2.5%。抗 B 的 IgM 滴度为 2.3%,IgG 滴度为 0.2%。危险 O 型血的流行率为 14.1%,而 A 型和 B 型血献血者中分别有 3.52% 和 10.5% 滴度较高。与高滴度相关的因素包括女性性别、素食、年龄 结论:这项研究揭示了 O、A 和 B 型献血者中高抗 A 和抗 B 滴度的流行率和相关性,并提供了补充信息。了解这些因素对于优化输血安全方案至关重要,包括血小板单位的选择性筛查和基于献血者特征的定制输血策略。
{"title":"Anti-A and anti-B titers in A, B and O whole blood donors: Beyond “dangerous O”","authors":"","doi":"10.1016/j.tracli.2024.06.007","DOIUrl":"10.1016/j.tracli.2024.06.007","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Hemolytic transfusion reactions (HTRs) pose significant risks in transfused patients, with anti-A and anti-B antibodies in donor plasma being potential contributing factors. Despite advancements in component preparation, HTRs remain a concern, particularly with apheresis-derived platelets. This study aimed to determine the prevalence of high anti-A and anti-B titers among A, B, and O blood group donors and to explore factors associated with high titers.</div></div><div><h3>Materials and Methods</h3><div>A cross-sectional observational study was conducted over 18 months, enrolling 978 participants from a tertiary care teaching hospital in Western India. Anti-A and anti-B titers were determined using the Conventional Tube Technique (CTT). Statistical analysis assessed correlations between high titers and demographic factors.</div></div><div><h3>Results</h3><div>The majority of participants were young males (98.8%). Prevalence of high titers for IgM anti-A was 12.2% and IgG anti-A was 2.5%. For anti-B, IgM titers were 2.3% and IgG titers were 0.2%. The prevalence of dangerous O was found to be 14.1%, while 3.52% and 10.5% of A and B blood group donors were found to have high titers, respectively. Factors associated with high titers included female gender, vegetarian diet, age <30 years, and O blood group.</div></div><div><h3>Conclusion</h3><div>The study sheds additional light and provides supplementary information regarding the prevalence and correlation of high anti-A and anti-B titers among O, A and B blood donors. Understanding these factors is crucial for optimizing transfusion safety protocols, including selective screening of platelet units and tailored transfusion strategies based on donor characteristics.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 4","pages":"Pages 195-200"},"PeriodicalIF":1.4,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-21DOI: 10.1016/j.tracli.2024.06.008
Introduction
ß-Thalassemia, a genetic condition which influences both the physical and emotional facets of individuals specially females while also exerting substantial financial strain on families and healthcare systems. Recognizing the pivotal influence of social support, particularly on mental well-being, this study endeavors to delve into the shared psychosocial challenges experienced by females grappling with ß-thalassemia major.
Methods
Employing a qualitative-descriptive methodology and purposive sampling, this study conducted in-depth interviews with forty-two young girls, 18.64 ± 4.27, diagnosed with ß-thalassemia major and representing diverse academic backgrounds, using a semi-structured in-depth interview guide. NVIVO-12 software facilitated extended data analysis, encompassing coding, categorization, theme development, and mind-mapping techniques to unravel nuanced insights from the collected data.
Findings
This groundbreaking study delves into the psychosocial factors that impact the well-being of female ß-thalassemia patients. The research highlights the key factors that positively contribute to their quality of life by conducting thorough inductive content analysis. These include receiving an education, having robust family support, experiencing overall life satisfaction, and making meaningful societal contributions. The findings of this study can be used to improve the lives of female ß-thalassemia patients and enhance their overall well-being. Contrariwise, notable impediments encompassed depression, social isolation, limited access to insurance services, challenges in educational and employment spheres, as well as difficulties in nurturing social relationships. These findings underscore the multifaceted influences shaping the quality of life for girls navigating ß-thalassemia, shedding light on empowering and challenging elements within their experiences.
Conclusion
In conclusion, psychosocial factors supporting or hindering the well-being of young girls with ß-thalassemia major in Pakistan include an inductive environment at homes, organizations, education, institutions with adequate knowledge of thalassemia disease among patients, and society. More research is needed to understand their needs and advocate for societal support and acceptance. Family and friends support are crucial for improving their quality of life, necessitating focused efforts to provide understanding and aid within the community.
{"title":"Exploring the perceptions and experiences of female’s with ß-thalassemia major in a Tertiary Care Private Hospital in Pakistan","authors":"","doi":"10.1016/j.tracli.2024.06.008","DOIUrl":"10.1016/j.tracli.2024.06.008","url":null,"abstract":"<div><h3>Introduction</h3><div>ß-Thalassemia, a genetic condition which influences both the physical and emotional facets of individuals specially females while also exerting substantial financial strain on families and healthcare systems. Recognizing the pivotal influence of social support, particularly on mental well-being, this study endeavors to delve into the shared psychosocial challenges experienced by females grappling with ß-thalassemia major.</div></div><div><h3>Methods</h3><div>Employing a qualitative-descriptive methodology and purposive sampling, this study conducted in-depth interviews with forty-two young girls, 18.64 ± 4.27, diagnosed with ß-thalassemia major and representing diverse academic backgrounds, using a semi-structured in-depth interview guide. NVIVO-12 software facilitated extended data analysis, encompassing coding, categorization, theme development, and mind-mapping techniques to unravel nuanced insights from the collected data.</div></div><div><h3>Findings</h3><div>This groundbreaking study delves into the psychosocial factors that impact the well-being of female ß-thalassemia patients. The research highlights the key factors that positively contribute to their quality of life by conducting thorough inductive content analysis. These include receiving an education, having robust family support, experiencing overall life satisfaction, and making meaningful societal contributions. The findings of this study can be used to improve the lives of female ß-thalassemia patients and enhance their overall well-being. Contrariwise, notable impediments encompassed depression, social isolation, limited access to insurance services, challenges in educational and employment spheres, as well as difficulties in nurturing social relationships. These findings underscore the multifaceted influences shaping the quality of life for girls navigating ß-thalassemia, shedding light on empowering and challenging elements within their experiences.</div></div><div><h3>Conclusion</h3><div>In conclusion, psychosocial factors supporting or hindering the well-being of young girls with ß-thalassemia major in Pakistan include an inductive environment at homes, organizations, education, institutions with adequate knowledge of thalassemia disease among patients, and society. More research is needed to understand their needs and advocate for societal support and acceptance. Family and friends support are crucial for improving their quality of life, necessitating focused efforts to provide understanding and aid within the community.</div></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 4","pages":"Pages 244-252"},"PeriodicalIF":1.4,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-21DOI: 10.1016/j.tracli.2024.06.006
{"title":"Blood type identification and pedigree analysis of D variant with RHD*01W.100/RHD*15","authors":"","doi":"10.1016/j.tracli.2024.06.006","DOIUrl":"10.1016/j.tracli.2024.06.006","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 4","pages":"Pages 267-269"},"PeriodicalIF":1.4,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12DOI: 10.1016/j.tracli.2024.06.004
Objectives
This study aims to demonstrate that utilizing a personalized approach to apheresis stem cell collection, can safely optimize the collection outcomes, especially in the context of poor mobilizers and high cell targets.
Background
The optimal mobilization and harvesting of peripheral blood stem cells is critical to the success of the stem cell transplant. The ideal strategy that promotes better cell yields, with sustainable use of resources and assuring patient safety, should be pursued.
Methods
PBSC collections for autologous stem cell transplant data according to a fixed-processed volume strategy (One Size Fits All) or individualized to patients CD34+ peripheral blood content and target approach (Custom-Tailored or CT) were retrospectively compared.
Results
A total of 263 collections from 142 patients were assessed. The majority of patients were male, had multiple myeloma and were mobilized with isolated G-CSF. The CT strategy promoted a significantly higher CD34+ cell yield when the pre-collection CD34 was lower than 20/µl (1.02 ± 0.16 versus 1.36 ± 0.23, p < 0.001) and also a decrease in the proportion of mobilization cycles that needed 3 apheresis (31% versus 14%, p = 0.02). There was no difference in apheresis-related adverse events between the groups.
Conclusion
Tailoring the apheresis procedures to the patient-specific characteristics and objectives, can effectively promote better patient outcome.
{"title":"Personalized autologous stem cell harvesting improves patient collection outcomes","authors":"","doi":"10.1016/j.tracli.2024.06.004","DOIUrl":"10.1016/j.tracli.2024.06.004","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aims to demonstrate that utilizing a personalized approach to apheresis stem cell collection, can safely optimize the collection outcomes, especially in the context of poor mobilizers and high cell targets.</p></div><div><h3>Background</h3><p>The optimal mobilization and harvesting of peripheral blood stem cells is critical to the success of the stem cell transplant. The ideal strategy that promotes better cell yields, with sustainable use of resources and assuring patient safety, should be pursued.</p></div><div><h3>Methods</h3><p>PBSC collections for autologous stem cell transplant data according to a fixed-processed volume strategy (One Size Fits All) or individualized to patients CD34+ peripheral blood content and target approach (Custom-Tailored or CT) were retrospectively compared.</p></div><div><h3>Results</h3><p>A total of 263 collections from 142 patients were assessed. The majority of patients were male, had multiple myeloma and were mobilized with isolated G-CSF. The CT strategy promoted a significantly higher CD34+ cell yield when the pre-collection CD34 was lower than 20/µl (1.02 ± 0.16 versus 1.36 ± 0.23, <em>p</em> < 0.001) and also a decrease in the proportion of mobilization cycles that needed 3 apheresis (31% versus 14%, <em>p</em> = 0.02). There was no difference in apheresis-related adverse events between the groups.</p></div><div><h3>Conclusion</h3><p>Tailoring the apheresis procedures to the patient-specific characteristics and objectives, can effectively promote better patient outcome.</p></div>","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 3","pages":"Pages 157-161"},"PeriodicalIF":1.4,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.1016/j.tracli.2024.06.003
{"title":"Icepack-Induced transient vasospasm leading to acrocyanosis in an Indian blood donor: A rare occurrence","authors":"","doi":"10.1016/j.tracli.2024.06.003","DOIUrl":"10.1016/j.tracli.2024.06.003","url":null,"abstract":"","PeriodicalId":23262,"journal":{"name":"Transfusion Clinique et Biologique","volume":"31 3","pages":"Pages 188-189"},"PeriodicalIF":1.4,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}