Indian Journal of Hematology and Blood Transfusion最新文献

Anemia in pregnancy is defined as Hb < 11 g/ dl. It is a huge burden causing death in around 80%. There is scanty literature available on prevalence of anaemia among pregnancy along with its determinants from Eastern India. The objective of our study was to assess the prevalence and aetiology of anaemia among pregnant mothers in urban population of eastern India. This is an observational, cross-sectional study conducted amongst the antenatal mothers visiting Lady Dufferin Hospital, Kolkata, West Bengal, India from - June 2010 to December 2021, for a duration of eleven years six months. Complete haemogram was performed after collecting 2cc EDTA blood sample. Other tests done include HPLC, serum ferritin, vitamin B 12, folate. 42349 antenatal mothers were enrolled in the study. 44.16% (18703/42349) of this study population had anaemia. Out of which, 1.5% had severe anaemia, 35.46% moderate and 63.02% had mild anaemia. The age range of the study population was 15 years 3 months to 46 years 1 month, with a mean age of 30 years 7 months. Of the entire cohort 9.5% ( 4023 / 42349 ) were detected to be thalassaemia carriers. Serum Ferritin level was less than 30ug/dl in 52.3% ( 9781/ 18703 ) of anaemic mothers. This study though documented a lower prevalence in urban mothers, the prevalence was higher compared to the global standards. The prevalence of anemia among teenage mothers was higher (59.78%) and anemia was more in primigravida (63.02% ), which indicates higher prevalence among the adolescents and young women. Anemia in most of the mother was mild ( 63.02% ), however some national as well as international studies reported moderate anemia as the most prevalent one. A significant percentage of pregnant women are anemic, which is significant in teenage pregnancies and primigravida. More importance to anemia control programs and mass awareness is needed to reduce the significant burden of anaemia.

Chronic myeloid leukemia (CML) is characterized by the BCR-ABL1 fusion oncogene, leading to increased tyrosine kinase activity. The current study was aimed to evaluate the impact of bone marrow fibrosis on the clinical outcomes of CML patients treated with second-generation tyrosine kinase inhibitor(TKI) among patients in Pakistan. A longitudinal study was conducted at National Institute of Blood Disease and Bone Marrow Transplantation (NIBD-BMT), Karachi, from October 2022 to October 2023. A total of 150 CML patients aged 18-80 years receiving second generation TKI were included. BM fibrosis was graded according to WHO criteria. Outcomes such as complete hematological response (CHR) and major molecular response (MMR) were evaluated at 3 and 6 months. Data were analyzed using SPSS version 25, with p-value of < 0.05. The median age of patients was 43.5 years, with male predominance (60.7%). BM fibrosis was present in 69.3% of patients at diagnosis. Patients with lower fibrosis grades (MF 0-1) had significantly higher rates of CHR at 3 months (73.5%) and MMR at 6 months (64.7%) compared to those with higher grade fibrosis (MF 2-3) with CHR of 66.7% and MMR of 50%. Optimal response rates were also higher in lower fibrosis grades (77.4% vs. 56.2%). Moreover, treatment failure was common with higher fibrosis grade. BM fibrosis is a critical factor influencing the response to TKIs in CML patients. Lower grades of fibrosis correlate with higher response rates and better clinical outcomes, suggesting the importance of early intervention and tailored treatment approaches based on fibrosis grading.

A 23-year-old man presented with worsening fatigue, coarse facial features, digital clubbing, and splenomegaly. Laboratory tests revealed severe anemia and bone marrow fibrosis. Genetic analysis identified a pathogenic mutation in the SLCO2A1 gene, confirming a diagnosis of autosomal recessive primary hypertrophic osteoarthropathy type 2 (PHOAR2). Treatment with Etoricoxib, a COX-2 inhibitor, led to gradual improvements in fatigue, reduction of spleen size, and increased hemoglobin levels over six months. This case highlights the association between elevated prostaglandin E2 levels and myelofibrosis in PHOAR2, emphasizing the potential of COX-2 inhibitors in managing symptoms.

Sickle cell disease is an inborn genetic blood disorder that is usually found among residents of Africa, Middle-East Gulf countries, and India. There has been increased knowledge and awareness of the range of neurological complications of Sickle cell disease (SCD) over the past 20 years. Silent neurologic involvement may occur in SCD and there's an opportunity of subclinical involvement in these patients presenting with vasoocclusive crisis. The case-control study was carried out after getting the institutional ethical clearance and obtaining consent from the patients and the controls. They were subjected to nerve conduction studies. Nerve conduction study was performed on median and tibial nerves for motor nerves, and median and sural for sensory nerves unilaterally. The nerves of the upper limb showed changes in neuropathy. The lower limb nerves were completely normal. In our study, we found out that Distal motor latency (DML) is prolonged in the Median motor nerve in cases as compared to controls suggesting motor neuropathy, and Sensory nerve action potential (SNAP) is reduced in the median sensory nerve suggesting sensory neuropathy. The nerve conduction studies in the tibial nerve were normal, suggesting subclinical neuropathy could be present in the patients with sickle cell presenting as mononeuropathy or mononeuritis multiplex. Our study also found a statistically significant correlation of neuropathy with the increasing number of hospital admissions for the vaso-occlusive crisis. Subclinical neuropathy is another manifestation of nervous system in patients with SCD and one should give adjuvant therapy of membrane stabilizing agents for the relief of pain. Detailed studies of this complication must be required further to evaluate its significance in clinical practice. We also conclude the aches and the pain the patient of sickle cell disease complains could not be always due to vaso-occlusive crisis, it could be the neuropathic pain which might mimic the ischemic pain.

Leukemia is one of the most common hematological malignancies. Cutaneous manifestations of leukemias consist of two groups: specific and non-specific. While the drug reactions, opportunistic infections due to myelosuppression are non-specific skin findings of leukemias, leukemia cutis is a specific sign of cutaneous involvement. In this retrospective study, we included patients over the age of 18 who were diagnosed with acute myeloid leukemia (AML) and underwent histopathological examination due to dermatological complaints. A total of 21 patients were included. Histopathological examination results were consistent with myeloid sarcoma, erythema nodosum, cutaneous drug eruption, necrosis due to vascular damage, cutaneous vasculitis, graft versus host disease, Sweet syndrome and viral infection. Dermatological examination plays an important role in AML patients. Skin biopsy and immunohistochemical examination should be performed to make early diagnosis of skin metastasis of leukemias and paraneoplastic syndromes to reduce the mortality and morbidity in AML patients.

Transfusion of Packed RBC units (PRBC) in multi-transfused patients often results in a progressive rise in transfusion requirements. To evaluate the procoagulant potential of PRBC in multi-transfused patients. We conducted this prospective cohort study (2020-2022) on multi-transfused patients (n = 31) having a lifetime transfusion of ≧ 4 units PRBCs. Biochemical parameters pre-, post-transfusion (≤ 24 hours) samples included, highly sensitive C reactive protein (HsCRP) for inflammation, LDH for hemolysis, tissue plasminogen activator (tPA), Antithrombin 3 (ATIII) levels as coagulopathy, anti-hemostatic marker and blood microparticle (MPs) (flowcytometry) as Annexin 5+ (AV+) events for TF. We performed Wilcoxon signed rank test (P≤ 0.05), pre-, posttransfusion (P≤ 0.05) and association pre- and posttransfusion by Spearman's rho correlation coefficient (CC), Linear regression (r²). Median (95% CI; P≤ 0.05) biochemical parameters pre-, posttransfusion, tPA {7.88 (2.63-20.44); 14.40 (5.29-27.08)} (P = 0.012) and ATIII {1299.66 (1078.5-1362.5); 1358.92 (1216 -1384.3)} (P = 0.011) respectively. A pre-, posttransfusion comparison of HsCRP (P = 0.45); LDH (P = 0.87) and MPs (number of events) (P = 0.54) pre-, posttransfusion were not significantly different. We observed a significant CC pre-posttransfusion HsCRP (0.61, P < 0.01); ATIII (0.480, P = 0.006); tPA (0.807, P < 0.01); MPs (0.625, P < 0.004) and r² tPA (posttransfusion) (dependent variable) tPA (pre-transfusion), ATIII (pre-transfusion) (predictor variables) r² = 0.85 (P < 0.01); ATIII (posttransfusion) (dependent variable) and ATIII (pre-transfusion); LDH (pre-transfusion) (predictor variable) r² = 0.45 (P = 0.026). A significant differences tPA, ATIII (pre-posttransfusion) and an association 'pre-posttransfusion' may be attributed to PRBC transfusions. tPA levels with corresponding changes in ATIII indicate coagulopathic response, following PRBC transfusions.

Supplementary information: The online version contains supplementary material available at 10.1007/s12288-025-01978-0.