Indian Journal of Hematology and Blood Transfusion最新文献

Low-incidence antigens are known to occur in less than 1% of individuals in most populations. Alloantibodies against low-frequency antigens pose a risk of potential hemolytic transfusion reactions and hemolytic disease in fetuses and newborns. We describe a technique of "Nonspecific alloadsorption" to identify a suspected antibody to a low-frequency antigen in the presence of an interfering autoantibody. A 15-year-old thalassaemic reported to our blood bank with an inability to find compatible blood units. There was a presence of an allo-antibody with auto-antibody. We attempted a "non-specific allo adsorption" for identifying an interfering allo-antibody against a low-frequency antigen. Our case report highlights that understanding the basic antigenic frequencies of various antigens can play an important role in antibody identification. It is always important to exclude alloantibody when autoantibody or AIHA scenarios are presented in thalassemia patients for safe transfusions.

Peripherally inserted central catheters (PICCs) are widely used in oncology patients for drug infusion and nutritional support; however, their usefulness for blood sample collection has not been clarified. This study aimed to evaluate the clinical acceptability of complete blood count (CBC) measurements in blood samples drawn from PICC lines in oncology patients. Blood samples were drawn twice successively from the PICC lines (PICC0 and PICC1 samples, respectively), and a peripheral blood collected from the contralateral limb was used as reference sample. Significant differences and sources of bias in the CBC measurements in two PICC samples were analyzed. Clinical acceptability was determined based on the total error allowance (TEa) rules. Except for hemoglobin and erythrocyte, no significant differences were observed in the other parameters between PICC1 and reference samples (all P > 0.05), including leukocyte, hematocrit, platelet, erythrocyte parameters and leukocyte differential counts. Deviations of erythrocyte and hemoglobin in PICC1 samples was only attributed to random error, whereas proportional bias were also observed in PICC0 samples. According to the given TEa, erythrocyte, leukocyte, hemoglobin, and platelet of the PICC1 samples met the 1/2 TEa criteria and had favorable clinical acceptability. However, the hematocrit and the three erythrocyte parameters failed to meet the 1/2 TEa criteria. Adherence to the TEa criteria may provide higher clinical acceptability for CBC results. Satisfactory results in oncology patients may be involve discarding the first 2 mL of blood samples during sample collection using PICC lines.

Background: The optimal goal in the management of refractory/relapsed classical Hodgkin lymphoma (R/R-cHL) is to obtain minimal disease status before stem cell transplantation (SCT). The efficiency of BEGEV (bendamustin, gemcitabine, vinorelbine) regimen is well-established as first-line salvage therapy in earlier studies. The search for novel treatment continues for patients with limited options in later lines. This study aimed to evaluate the efficacy of BEGEV regimen in heavily pretreated, platinum-resistant, R/R-cHL.

Methods: In this single-center retrospective trial, patients diagnosed with R/R-cHL between 2018 and 2023 were analyzed. Patients who received BEGEV in third- or fourth-line treatment were eligible. Patient's demographic characteristics, pathology results, treatment and survival outcomes were recorded. Overall survival (OS), objective response rate (ORR), progression free survival (PFS) and toxicity were analyzed.

Results: A total of 31 patients were included in this study. 27 (87.2%) patients were treated with BEGEV in the 3rd line and 4 (12.8%) patients were treated in the 4th line. The results show an ORR of 90.3%, with 54.9% achieving complete response. The median PFS and OS after the BEGEV regimen was 20.2 (range 15-23.6) and 23.2 (range 15.4-40.8) months, respectively. The regimen demonstrated acceptable toxicity, with the most common severe adverse events being neutropenia and thrombocytopenia. SCT was successfully performed in 100% of the patients after BEGEV treatment.

Conclusion: Our findings suggest that BEGEV is a viable and effective treatment option for heavily pretreated, platinum-resistant R/R-cHL patients, particularly in regions with limited access to novel therapies.

Thyroid dysfunction has been reported as an adverse effect of imatinib mesylate. However, the risk factors associated with this adverse effect in CML patients have not been elucidated. We investigated the baseline parameters (Age, BCR::ABL1 ratio, Sokal, Hasford, and EUTO scores) of the CML patients as predictors of thyroid dysfunction. This longitudinal study included 50 Imatinib naïve CML patients. Serum TSH, fT3, and fT4 were done for each subject at recruitment and 1, 3, and 6 months on Imatinib. These patients were classified into CML1(patients who remained euthyroid) and CML2(patients with thyroid dysfunction). The relationship of these parameters with the serum TSH and the difference between the two groups were determined. Thyroid dysfunction was observed in 7 patients (6 females and 1 male) at 6 months only. The mean ± SD of the PCV, Sokal score and Hasford scores of the two groups (CML1 vs. CML 2) were (28.67±5.54 vs24.00 ± 4.80 t=2.121, p-value=0.039*), (0.94±0.31vs1.25 ± 0.6 t=-2.061, p-value=0.045*) and (927.09±488.17vs1426.25±630.45 t=-2.410, p-value=0.020*) respectively. Serum TSH correlated positively with Sokal score (r=0.399,p-value=0.039*) and BCR::ABL1(r=0.311,p-value =0.028*). This study has identified high Sokal score and BCR::ABL1 transcript ratio at diagnosis as predictors of imatinib-induced thyroid dysfunction.

The aim of this study was to investigate the effectiveness and safety of low dose cyclophosphamide (Cy) as a mobilization regimen in multiple myeloma and lymphoma patients during covid-19. This is a single-center retrospective study conducted at Stem Cell Transplantation Unit of University of Health Sciences Adana City Training and Research Hospital, between September 2020 and August 2022. Fourty-one patients who underwent stem cell mobilization with low dose cyclophosphamide plus granulocyte colony stimulating factor (G-CSF) were included. Cyclophosphamide was administered with a dosage of 2000 mg/m²/day for one day and G-CSF was started at a dosage of 10 μg/kg/day 2 or 5 days after the Cy application and was continued until obtaining adequate product or mobilization failure. The median age of the patients at the time of mobilization was 57 years (range, 21-68). Eighteen (43.9%) patients were female and 23 (56.1%) were male. An adequate number of CD34⁺ cells were collected in 38 (92.7%) patients with a product yield of ≥ 2 × 10⁶/kg CD34 + cells while the rate of mobilization failure was 7.3% (3 of 41). In conclusion, low dose Cy with G-CSF seems to be an effective mobilization regimen prior to ASCT with a reasonable toxicity in the era of Covid-19 disease.

[This corrects the article DOI: 10.1007/s12288-024-01887-8.].

Despite the critical importance of blood donations in healthcare systems, many potential donors still need to be more confident. This study aimed to identify and analyze the factors contributing to blood donation reluctance among university students. A cross-sectional survey was conducted among 312 university students to gather data on the reasons for reluctance to donate blood. The survey included questions on demographics, knowledge, attitudes, and beliefs regarding blood donation. Data pre-processing involved handling missing values and converting categorical responses into a numerical format suitable for machine learning analysis. K-means clustering was applied to categorize the responses into distinct groups. The optimal number of clusters was determined using silhouette scores, which resulted in the identification of eight distinct clusters. The eight clusters represented unique concerns, ranging from health-related misconceptions to logistical barriers. Key findings indicated that certain clusters were predominantly concerned with myths about health impacts, fear of needles, and a lack of awareness regarding the blood donation process. The results underscore the need for targeted educational campaigns to address specific misconceptions and informational gaps identified within each cluster. Strategic, data-driven outreach programs could significantly mitigate these barriers and potentially increase student participation in blood donation. Future research should explore longitudinal data to assess the effectiveness of tailored interventions and expand scope of the study to include diverse demographic groups to further generalize these findings.