INTRODUCTION: Basophilia can help stratify cases of chronic myeloid leukemia (CML) into different phases and monitor response to therapy and has a significant prognostic value. It helps differentiate patients of CML from those with leukemoid reaction. Basophil counts (BCs) given by automated hematology analyzers are often not reliable. Analysis of peripheral blood picture therefore holds its importance in these cases. In this study, we aim to compare the BC in patients with suspected CML using two automated analyzers with manual microscopy. MATERIALS AND METHODS: Two hundred and sixty-nine ethylenediaminetetraacetic acid samples identified as suspected CML run on Beckman Coulter UniCel DxH 800 and Sysmex XN-1000 were analyzed for BC microscopically on Giemsa-stained peripheral smear slides by two pathologists. The mean of basophil counts obtained microscopically was considered to be standard. They were compared with BC given by automated counters using correlation analysis and Bland Altman plots. RESULTS: The age of the patients ranged from 4 to 89 years, with a male-to-female ratio of 1.2:1 (148 males; 121 females). BC obtained among both analyzers did not correlate (r2 = 0.14). Results of microscopically counted basophils correlated well among two pathologists (r2 = 0.92). Bland–Altman plots showed a mean bias of 2.2% and 2.4% by XN-1000 and DxH 800, respectively, when compared with manual counts. In the frequency distribution analysis, XN-1000 missed all 10 cases with BC >20% whereas DxH 800 missed 3/10 cases with BC >20%. In addition, in the 10%–20% range of BC, XN-1000 identified 6/22 cases whereas DxH 800 identified 12/22 cases. In the 5%–10% range of BC, XN-1000 identified 59/78 cases whereas DxH 800 identified only 43/78 cases. CONCLUSION: With lower BC, Sysmex XN-1000 and, at higher BC, Beckman Coulter DxH 800 showed better performance. However, BC from none of the analyzers can be used alone without consideration of the microscopic results. All smears should be manually counted for basophils in cases of suspected CML because of its importance in clinical management.
{"title":"Comparison of basophil count by Beckman Coulter UniCel DxH 800, Sysmex XN-1000, and manual microscopy in cases of suspected chronic myeloid leukemia","authors":"P. Chopra, Sunanda Bhardwaj, Anil Arora","doi":"10.4103/ijh.ijh_9_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_9_21","url":null,"abstract":"INTRODUCTION: Basophilia can help stratify cases of chronic myeloid leukemia (CML) into different phases and monitor response to therapy and has a significant prognostic value. It helps differentiate patients of CML from those with leukemoid reaction. Basophil counts (BCs) given by automated hematology analyzers are often not reliable. Analysis of peripheral blood picture therefore holds its importance in these cases. In this study, we aim to compare the BC in patients with suspected CML using two automated analyzers with manual microscopy. MATERIALS AND METHODS: Two hundred and sixty-nine ethylenediaminetetraacetic acid samples identified as suspected CML run on Beckman Coulter UniCel DxH 800 and Sysmex XN-1000 were analyzed for BC microscopically on Giemsa-stained peripheral smear slides by two pathologists. The mean of basophil counts obtained microscopically was considered to be standard. They were compared with BC given by automated counters using correlation analysis and Bland Altman plots. RESULTS: The age of the patients ranged from 4 to 89 years, with a male-to-female ratio of 1.2:1 (148 males; 121 females). BC obtained among both analyzers did not correlate (r2 = 0.14). Results of microscopically counted basophils correlated well among two pathologists (r2 = 0.92). Bland–Altman plots showed a mean bias of 2.2% and 2.4% by XN-1000 and DxH 800, respectively, when compared with manual counts. In the frequency distribution analysis, XN-1000 missed all 10 cases with BC >20% whereas DxH 800 missed 3/10 cases with BC >20%. In addition, in the 10%–20% range of BC, XN-1000 identified 6/22 cases whereas DxH 800 identified 12/22 cases. In the 5%–10% range of BC, XN-1000 identified 59/78 cases whereas DxH 800 identified only 43/78 cases. CONCLUSION: With lower BC, Sysmex XN-1000 and, at higher BC, Beckman Coulter DxH 800 showed better performance. However, BC from none of the analyzers can be used alone without consideration of the microscopic results. All smears should be manually counted for basophils in cases of suspected CML because of its importance in clinical management.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"91 - 96"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43138097","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}
Shlan Muhammad, Ahmed K. Yassin, Rawand P. Shamoon, N. Mohammed, Marwa Nadhim, Kawa Hassan, BryarSabah Rashid, Shokhan Mohammad, Ranan Karadagh, G. Numan, L. Abdulrahman, S. Jalal, Zhala Ahmed, H. Getta, Tavan I. Mahmood, Basil K. Abdulla, D. Abdullah, Rozh-hatA Yousif, Z. Mohamed
BACKGROUND: Chronic lymphocytic leukemia is an uncommon type of leukemia in Iraq, although many reported cases of chronic lymphocytic leukemia in the Iraqi Kurdistan region are of high risk stage. Staging of chronic lymphocytic leukemia is essential in treatment planning and for disease prognosis. the aims of this study were to find out the difference in patients' survival with early and late clinical stages, and to evaluate CLL outcome in relation to the Rai and Binet staging. PATIENTS AND METHODS: This retrospective cross-sectional analysis studied 250 patients, 170 male and 80 female, with chronic lymphocytic leukemia who were registered in three hemato-oncology centers in Iraqi Kurdistan for the last 10 years. The diagnosis of the disease was made according to the guideline of the International Workshop Chronic Lymphocytic Leukemia update of the National Cancer Institute. The patients' clinical staging was determined by a senior hematologist based on the clinical and laboratory findings. RESULTS: The mean age of the patients was 63(±11.8) years, 40% were >65 years. The median survival was 27 months. Elderly patients >65 years had significantly lower mean survival. The Rai staging was distributed as follows: stage 0 (24.8%), stage I (12.8%), stage II (30.8%), stage III (9.6%) and stage IV (22%). The median survival was significantly higher among patients with Rai stage 0 comparing to patients with advanced stages (P<0.001). The Binet stage was distributed as follows: stage A (47.2%), stage B (26.4%) and stage C (26.4%). The median patients' survival was significantly higher among patients with Binet stage A comparing to those with Binet stage C (P<0.001). CONCLUSIONS: The survival of patients with chronic lymphocytic leukemia strongly related to the clinical stages of both staging systems.
{"title":"The significance of Rai and Binet clinical staging on the survival of chronic lymphocytic leukemia patients in the Kurdistan region of Iraq","authors":"Shlan Muhammad, Ahmed K. Yassin, Rawand P. Shamoon, N. Mohammed, Marwa Nadhim, Kawa Hassan, BryarSabah Rashid, Shokhan Mohammad, Ranan Karadagh, G. Numan, L. Abdulrahman, S. Jalal, Zhala Ahmed, H. Getta, Tavan I. Mahmood, Basil K. Abdulla, D. Abdullah, Rozh-hatA Yousif, Z. Mohamed","doi":"10.4103/ijh.ijh_23_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_23_21","url":null,"abstract":"BACKGROUND: Chronic lymphocytic leukemia is an uncommon type of leukemia in Iraq, although many reported cases of chronic lymphocytic leukemia in the Iraqi Kurdistan region are of high risk stage. Staging of chronic lymphocytic leukemia is essential in treatment planning and for disease prognosis. the aims of this study were to find out the difference in patients' survival with early and late clinical stages, and to evaluate CLL outcome in relation to the Rai and Binet staging. PATIENTS AND METHODS: This retrospective cross-sectional analysis studied 250 patients, 170 male and 80 female, with chronic lymphocytic leukemia who were registered in three hemato-oncology centers in Iraqi Kurdistan for the last 10 years. The diagnosis of the disease was made according to the guideline of the International Workshop Chronic Lymphocytic Leukemia update of the National Cancer Institute. The patients' clinical staging was determined by a senior hematologist based on the clinical and laboratory findings. RESULTS: The mean age of the patients was 63(±11.8) years, 40% were >65 years. The median survival was 27 months. Elderly patients >65 years had significantly lower mean survival. The Rai staging was distributed as follows: stage 0 (24.8%), stage I (12.8%), stage II (30.8%), stage III (9.6%) and stage IV (22%). The median survival was significantly higher among patients with Rai stage 0 comparing to patients with advanced stages (P<0.001). The Binet stage was distributed as follows: stage A (47.2%), stage B (26.4%) and stage C (26.4%). The median patients' survival was significantly higher among patients with Binet stage A comparing to those with Binet stage C (P<0.001). CONCLUSIONS: The survival of patients with chronic lymphocytic leukemia strongly related to the clinical stages of both staging systems.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"146 - 151"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43602898","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}
S. Mustafa, Ahmed K. Yassin, N. Mohammed, Rawand P. Shamoon, M. Karam, ShlanS Mohammad, L. Abdulrahman, Zhalla O. Ahmed, BryarSabah Rashid, Tavan I. Mahmood, Rozh-hatA Yousif, Kawa M. Hasan, Z. Mohamed, H. Getta, S. Jalal, D. Abdullah, Basil K. Abdulla, G. Numan, Ranan Karadagh
BACKGROUND: Chronic lymphocytic leukemia (CLL) is characterized by a lower incidence rate in Iraq and Kurdistan as compared to Western countries. However, a good prognosis of CLL is dependable on diagnosis, risk stratification, and a better choice of an appropriate treatment regimen. AIM OF THE STUDY: To evaluate the effectiveness of fludarabine, cyclophosphamide, and rituximab (FCR) regimen in comparison to other chemotherapy regimens in the management of patients with CLL in Kurdistan region/Iraq. PATIENTS AND METHODS: A retrospective review study carried out in three cancer centers in the Kurdistan region of Iraq for the duration of 10 years through the period from January 1, 2010 to December 31, 2019, on 152 CLL patients. CLL was diagnosed according to the International Workshop on CLL. The treatment of CLL patients was either by FCR chemo-immunotherapy regimen or other chemotherapies. RESULTS: The FCR chemo-immunotherapy was the treatment of 38.8% of CLL patients, while 61.2% of CLL patients were treated by other chemotherapies. There was a significant association between younger age patients and the use FCR chemo-immunotherapy (P = 0.001). There was a significant association between a complete response and treatment by FCR chemo-immunotherapy (P = 0.02). The mean overall survival duration and progression-free survival of CLL patients treated by FCR chemo-immunotherapy were significantly longer than the mean survival time of CLL patients treated by other chemotherapies (P = 0.01). CONCLUSIONS: Complete response and survival of CLL patients treated by FCR chemo-immunotherapy were better than the complete response and survival of CLL patients treated by other chemotherapies.
{"title":"Long-term survival after fludarabine, cyclophosphamide, and rituximab treatment in previously untreated chronic lymphocytic leukemia patients","authors":"S. Mustafa, Ahmed K. Yassin, N. Mohammed, Rawand P. Shamoon, M. Karam, ShlanS Mohammad, L. Abdulrahman, Zhalla O. Ahmed, BryarSabah Rashid, Tavan I. Mahmood, Rozh-hatA Yousif, Kawa M. Hasan, Z. Mohamed, H. Getta, S. Jalal, D. Abdullah, Basil K. Abdulla, G. Numan, Ranan Karadagh","doi":"10.4103/ijh.ijh_22_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_22_21","url":null,"abstract":"BACKGROUND: Chronic lymphocytic leukemia (CLL) is characterized by a lower incidence rate in Iraq and Kurdistan as compared to Western countries. However, a good prognosis of CLL is dependable on diagnosis, risk stratification, and a better choice of an appropriate treatment regimen. AIM OF THE STUDY: To evaluate the effectiveness of fludarabine, cyclophosphamide, and rituximab (FCR) regimen in comparison to other chemotherapy regimens in the management of patients with CLL in Kurdistan region/Iraq. PATIENTS AND METHODS: A retrospective review study carried out in three cancer centers in the Kurdistan region of Iraq for the duration of 10 years through the period from January 1, 2010 to December 31, 2019, on 152 CLL patients. CLL was diagnosed according to the International Workshop on CLL. The treatment of CLL patients was either by FCR chemo-immunotherapy regimen or other chemotherapies. RESULTS: The FCR chemo-immunotherapy was the treatment of 38.8% of CLL patients, while 61.2% of CLL patients were treated by other chemotherapies. There was a significant association between younger age patients and the use FCR chemo-immunotherapy (P = 0.001). There was a significant association between a complete response and treatment by FCR chemo-immunotherapy (P = 0.02). The mean overall survival duration and progression-free survival of CLL patients treated by FCR chemo-immunotherapy were significantly longer than the mean survival time of CLL patients treated by other chemotherapies (P = 0.01). CONCLUSIONS: Complete response and survival of CLL patients treated by FCR chemo-immunotherapy were better than the complete response and survival of CLL patients treated by other chemotherapies.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"139 - 145"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41836430","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}
BACKGROUND: Neonatal sepsis is a life-threatening condition which needs urgent diagnosis and proper management. Blood culture and sepsis screening are currently used methods, but their utility is limited due to delayed reporting and increased cost. However, in newborn infants, a close relationship between sepsis and thrombocytopenia and other changes in platelet indices such as increased mean platelet volume (MPV) and platelet distribution width (PDW) has been suggested by few studies. OBJECTIVE: This study aimed to assess the diagnostic value of platelet indices in the early detection of neonatal sepsis. MATERIALS AND METHODS: A retrospective study with diagnostic testing was carried out by collecting data from medical records of neonates with neonatal sepsis who were admitted to the Neonatology Department in DR. B. C Roy PGIPS, Kolkata, over the period from January 2019 to December 2019. One hundred neonates were included in the study, 50 were proven to have sepsis by culture, and others are used as controls (apparently healthy babies). Sensitivity, specificity, positive predictive value, and negative predictive value of platelet count, MPV, and PDW in neonatal sepsis were determined using a 2 × 2 table. RESULTS: The platelet count was significantly decreased, whereas PDW and MPV were increased in septic babies (P < 0.0001). CONCLUSION: Platelet indices can be used to diagnose neonatal sepsis as easily available and cheaper markers.
背景:新生儿脓毒症是一种危及生命的疾病，需要紧急诊断和适当的治疗。目前使用的方法是血培养和败血症筛查，但由于报告延迟和成本增加，其效用有限。然而，在新生儿中，脓毒症与血小板减少症之间的密切关系以及其他血小板指标的变化，如平均血小板体积(MPV)和血小板分布宽度(PDW)的增加，很少有研究提出。目的:探讨血小板指标在新生儿脓毒症早期诊断中的价值。材料和方法:通过收集2019年1月至2019年12月期间加尔各答DR. b.c Roy PGIPS新生儿科收治的新生儿败血症患儿的医疗记录数据，进行了一项具有诊断测试的回顾性研究。100名新生儿参与了这项研究，其中50名通过培养证实患有败血症，其他的作为对照(显然是健康的婴儿)。采用2 × 2表测定血小板计数、MPV和PDW在新生儿脓毒症中的敏感性、特异性、阳性预测值和阴性预测值。结果:脓毒症患儿血小板计数显著降低，而PDW和MPV升高(P < 0.0001)。结论:血小板指标可作为诊断新生儿脓毒症的一种简便、廉价的指标。
{"title":"Platelet indices as an earlier and economical marker of neonatal sepsis","authors":"A. Majumdar, Soumali Biswas, Angshuman Jana","doi":"10.4103/ijh.ijh_15_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_15_21","url":null,"abstract":"BACKGROUND: Neonatal sepsis is a life-threatening condition which needs urgent diagnosis and proper management. Blood culture and sepsis screening are currently used methods, but their utility is limited due to delayed reporting and increased cost. However, in newborn infants, a close relationship between sepsis and thrombocytopenia and other changes in platelet indices such as increased mean platelet volume (MPV) and platelet distribution width (PDW) has been suggested by few studies. OBJECTIVE: This study aimed to assess the diagnostic value of platelet indices in the early detection of neonatal sepsis. MATERIALS AND METHODS: A retrospective study with diagnostic testing was carried out by collecting data from medical records of neonates with neonatal sepsis who were admitted to the Neonatology Department in DR. B. C Roy PGIPS, Kolkata, over the period from January 2019 to December 2019. One hundred neonates were included in the study, 50 were proven to have sepsis by culture, and others are used as controls (apparently healthy babies). Sensitivity, specificity, positive predictive value, and negative predictive value of platelet count, MPV, and PDW in neonatal sepsis were determined using a 2 × 2 table. RESULTS: The platelet count was significantly decreased, whereas PDW and MPV were increased in septic babies (P < 0.0001). CONCLUSION: Platelet indices can be used to diagnose neonatal sepsis as easily available and cheaper markers.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"108 - 111"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45722405","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}
Moumita Adhikary, Mohua Mazumdar, S. Mukhopadhyay, J. Phukan, Prosanta Sana, B. Jain
INTRODUCTION: Blood transfusion is essential for saving lives in millions of patients. However, blood transfusion also carries the risk of transfusion-transmissible infections (TTIs) if not properly screened. AIMS AND OBJECTIVES : To study the seroprevalence of TTI among blood donors in a blood bank with special emphasis on hepatitis B and hepatitis C. MATERIALS AND METHODS: It is a retrospective descriptive study for 5 years from January 2016 to December 2020. Data of all blood donors both voluntary and involuntary were analyzed to find out seroprevalence of TTIs. RESULTS: Total 43775 donors were screened, and their data were analyzed. Out of these, total 182 (0.42%) donors were found to be seropositive for TTIs. Most of the donors were positive for hepatitis B (n = 122, 0.28%) and hepatitis C (n = 51; 0.12%); however, no donor was found to be positive for malaria. CONCLUSION: In this study, we found a low prevalence rate of TTIs among blood donors. It may be due to effective screening and selection of donors as well as awareness among general public. Strict screening and regular testing are essential to keep blood transfusion safe and free from TTIs.
{"title":"Seroprevalence of transfusion-transmitted infections among blood donors in a newly established medical college of Eastern India","authors":"Moumita Adhikary, Mohua Mazumdar, S. Mukhopadhyay, J. Phukan, Prosanta Sana, B. Jain","doi":"10.4103/ijh.ijh_20_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_20_21","url":null,"abstract":"INTRODUCTION: Blood transfusion is essential for saving lives in millions of patients. However, blood transfusion also carries the risk of transfusion-transmissible infections (TTIs) if not properly screened. AIMS AND OBJECTIVES : To study the seroprevalence of TTI among blood donors in a blood bank with special emphasis on hepatitis B and hepatitis C. MATERIALS AND METHODS: It is a retrospective descriptive study for 5 years from January 2016 to December 2020. Data of all blood donors both voluntary and involuntary were analyzed to find out seroprevalence of TTIs. RESULTS: Total 43775 donors were screened, and their data were analyzed. Out of these, total 182 (0.42%) donors were found to be seropositive for TTIs. Most of the donors were positive for hepatitis B (n = 122, 0.28%) and hepatitis C (n = 51; 0.12%); however, no donor was found to be positive for malaria. CONCLUSION: In this study, we found a low prevalence rate of TTIs among blood donors. It may be due to effective screening and selection of donors as well as awareness among general public. Strict screening and regular testing are essential to keep blood transfusion safe and free from TTIs.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"134 - 138"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45866361","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}
CONTEXT : Hemoglobin H (HbH) disease is induced by mutations in three out of the four α- globin genes. Most commonly, mutations are either deletional or nondeletional. While some deletions (3.7 and 4.2) induce α+ thalassemia, others induce (20.5, MED, THA1, FIL) α0 thalassemia. HbH disease is a combination of both. AIMS : This study aimed to describe alpha-thalassemia (HbH disease) mutations in Suliamaniyah Province, Iraq. MATERIALS AND METHODS : Fifty-one patients with hypochromic microcytic anemia were evaluated for HbH disease. For each patient, a 2-ml venous blood sample was taken for isolating DNA. The samples were inspected for HbH disease mutations by gel electrophoresis, applying the α-Globin Strip Assay from the Vienna Lab TM commercial kit. STATISTICAL ANALYSIS: Microsoft Excel software was used to analyze data. RESULTS : Clinical data from complete blood count, hemoglobin (Hb)-electrophoresis, and HbH test were measured. HbH patients had significantly low levels of mean corpuscular volume, mean corpuscular Hb, and Hb (HGB) compared to normal values, and all showed a positive result in the HbH test with a low level of HbA2. Both the Med double gene deletion (3.7/MED) and the 3.7 single-gene deletion were detected in 68.62% of patients. Single-gene deletion 4.2, double gene deletion 20.5 (4.2/20.5), double gene deletion Med, and point mutation α2 poly A2 (MED/α2 poly A2) were all found in 1.96% of patients. CONCLUSION : There is no difference between the phenotypes of patients with different genotypes.
{"title":"Description of hemoglobin H disease mutations in alpha thalassemia patients in Sulaimani Region in Kurdistan Region, Iraq","authors":"Lena Amin, Luqman Rasool, B. Nore, G. Salih","doi":"10.4103/ijh.ijh_12_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_12_21","url":null,"abstract":"CONTEXT : Hemoglobin H (HbH) disease is induced by mutations in three out of the four α- globin genes. Most commonly, mutations are either deletional or nondeletional. While some deletions (3.7 and 4.2) induce α+ thalassemia, others induce (20.5, MED, THA1, FIL) α0 thalassemia. HbH disease is a combination of both. AIMS : This study aimed to describe alpha-thalassemia (HbH disease) mutations in Suliamaniyah Province, Iraq. MATERIALS AND METHODS : Fifty-one patients with hypochromic microcytic anemia were evaluated for HbH disease. For each patient, a 2-ml venous blood sample was taken for isolating DNA. The samples were inspected for HbH disease mutations by gel electrophoresis, applying the α-Globin Strip Assay from the Vienna Lab TM commercial kit. STATISTICAL ANALYSIS: Microsoft Excel software was used to analyze data. RESULTS : Clinical data from complete blood count, hemoglobin (Hb)-electrophoresis, and HbH test were measured. HbH patients had significantly low levels of mean corpuscular volume, mean corpuscular Hb, and Hb (HGB) compared to normal values, and all showed a positive result in the HbH test with a low level of HbA2. Both the Med double gene deletion (3.7/MED) and the 3.7 single-gene deletion were detected in 68.62% of patients. Single-gene deletion 4.2, double gene deletion 20.5 (4.2/20.5), double gene deletion Med, and point mutation α2 poly A2 (MED/α2 poly A2) were all found in 1.96% of patients. CONCLUSION : There is no difference between the phenotypes of patients with different genotypes.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"97 - 101"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47368890","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}
Ahmed Mjali, Alyaa Oudah, H. Al-Shammari, N. Abbas
BACKGROUND: Non-Hodgkin lymphoma (NHL) patterns vary worldwide in relation to demographic and environmental factors. AIM: The objective of our study was to identify subtypes of NHL in the Middle Euphrates Region of Iraq according to the World Health Organization (WHO) modified classification. MATERIALS AND METHODS: A retrospective descriptive study was carried out at Al-Hussein Cancer Center in Karbala, Iraq, on 385 patients diagnosed with NHL between January 2012 and August 2020. Patient ages ranged between 1 and 96 years. They included 204 males and 181 females. All patients were diagnosed by tissue biopsy, confirmed by immunohistochemistry markers, and classified according to WHO classification. Any patient with inconclusive results was excluded from the study. RESULTS: Among total NHL patients, males were (53%) and females were (47%) with a male: female ratio of (1.12:1). B-cell lymphoma was diagnosed in (92.47%) and T cell lymphoma in (7.53%). Diffuse large B-cell Lymphoma (DLBCL) was the most frequent B-cell subtype (54.02%) followed by Burkitt's lymphoma (BL) (14.02%), while peripheral T-cell lymphoma was the most common T-cell subtype (2.08%). About (61.82%) of patients were nodal, and (38.18%) were extranodal. The intestine was the most frequent extranodal site (34.69%). CONCLUSION: Among our patients, there were high frequencies of DLBCL, extra nodal primaries and intestinal BL. Follicular lymphoma and small lymphocytic lymphoma were uncommon in our region. These results were similar to the Middle Eastern NHL patterns but differed from the western patterns.
{"title":"Classification of non-Hodgkin lymphoma in the Middle Euphrates Region of Iraq according to the World Health Organization classification","authors":"Ahmed Mjali, Alyaa Oudah, H. Al-Shammari, N. Abbas","doi":"10.4103/ijh.ijh_34_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_34_21","url":null,"abstract":"BACKGROUND: Non-Hodgkin lymphoma (NHL) patterns vary worldwide in relation to demographic and environmental factors. AIM: The objective of our study was to identify subtypes of NHL in the Middle Euphrates Region of Iraq according to the World Health Organization (WHO) modified classification. MATERIALS AND METHODS: A retrospective descriptive study was carried out at Al-Hussein Cancer Center in Karbala, Iraq, on 385 patients diagnosed with NHL between January 2012 and August 2020. Patient ages ranged between 1 and 96 years. They included 204 males and 181 females. All patients were diagnosed by tissue biopsy, confirmed by immunohistochemistry markers, and classified according to WHO classification. Any patient with inconclusive results was excluded from the study. RESULTS: Among total NHL patients, males were (53%) and females were (47%) with a male: female ratio of (1.12:1). B-cell lymphoma was diagnosed in (92.47%) and T cell lymphoma in (7.53%). Diffuse large B-cell Lymphoma (DLBCL) was the most frequent B-cell subtype (54.02%) followed by Burkitt's lymphoma (BL) (14.02%), while peripheral T-cell lymphoma was the most common T-cell subtype (2.08%). About (61.82%) of patients were nodal, and (38.18%) were extranodal. The intestine was the most frequent extranodal site (34.69%). CONCLUSION: Among our patients, there were high frequencies of DLBCL, extra nodal primaries and intestinal BL. Follicular lymphoma and small lymphocytic lymphoma were uncommon in our region. These results were similar to the Middle Eastern NHL patterns but differed from the western patterns.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"170 - 175"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42272835","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}
M. Badawi, Rakan Saaty, Sarah Altayyari, Roaa Khalil, F. Moria, Galila Zaher, Salwa A. Alnajjar, S. Hindawi
BACKGROUND: Tracking transfusion reactions is essential to improve patient safety. Under-reporting of transfusion reactions was suspected in our institution. To evaluate this phenomenon, we followed an active surveillance protocol for transfusion reactions for 3 months in 2016 and compared transfusion reaction rates during that period with 2015 and 2017. METHODS: The study was carried out in a tertiary care hospital over 3 months in 2016. Investigators visited hospital units and collected data on all patients who received a transfusion in the preceding 24 h. Further details were obtained about all cases that are suspected to have had a transfusion reaction. Transfusion reactions were defined according to the definitions provided by National Healthcare Safety Network Biovigilance Component Hemovigilance Module Surveillance Protocol 2016. Rates that were obtained through active surveillance were compared through appropriate statistical methods with transfusion reaction rates obtained through passive reporting from 2015 and 2017. RESULTS: During the study period, a total of 47 transfusion reactions were captured through active surveillance and passive reporting (transfusion reaction rate 0.79%). There was a statistically significant difference between these rates in comparison with rates detected in similar months from 2015 (0.26%) and 2017 (0.17%). CONCLUSIONS: Active surveillance for transfusion reactions is an effective method for improving rates of the detection of suspected transfusion reactions. The phenomenon of under-reporting of transfusion reactions requires thorough evaluation by transfusion medicine professionals to introduce targeted solutions and improve reporting rates.
{"title":"Improving detection rates of suspected acute transfusion reactions through active surveillance","authors":"M. Badawi, Rakan Saaty, Sarah Altayyari, Roaa Khalil, F. Moria, Galila Zaher, Salwa A. Alnajjar, S. Hindawi","doi":"10.4103/ijh.ijh_31_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_31_21","url":null,"abstract":"BACKGROUND: Tracking transfusion reactions is essential to improve patient safety. Under-reporting of transfusion reactions was suspected in our institution. To evaluate this phenomenon, we followed an active surveillance protocol for transfusion reactions for 3 months in 2016 and compared transfusion reaction rates during that period with 2015 and 2017. METHODS: The study was carried out in a tertiary care hospital over 3 months in 2016. Investigators visited hospital units and collected data on all patients who received a transfusion in the preceding 24 h. Further details were obtained about all cases that are suspected to have had a transfusion reaction. Transfusion reactions were defined according to the definitions provided by National Healthcare Safety Network Biovigilance Component Hemovigilance Module Surveillance Protocol 2016. Rates that were obtained through active surveillance were compared through appropriate statistical methods with transfusion reaction rates obtained through passive reporting from 2015 and 2017. RESULTS: During the study period, a total of 47 transfusion reactions were captured through active surveillance and passive reporting (transfusion reaction rate 0.79%). There was a statistically significant difference between these rates in comparison with rates detected in similar months from 2015 (0.26%) and 2017 (0.17%). CONCLUSIONS: Active surveillance for transfusion reactions is an effective method for improving rates of the detection of suspected transfusion reactions. The phenomenon of under-reporting of transfusion reactions requires thorough evaluation by transfusion medicine professionals to introduce targeted solutions and improve reporting rates.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"165 - 169"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42343885","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}
BACKGROUND: Hemophilia A patients, especially if there is shortage in recombinant Factor VIII concentrate, may require occasional blood and/blood products transfusion, rendering them more susceptible to acquire infections including Parvo B19 virus (B19V). OBJECTIVES: To assess the presence of B19V viral DNA among hemophilia A patients and look for its possible association with disease-related variables. SUBJECTS AND METHODS: This case–control study was carried out from October 2019 to August 2020. A total of 95 male patients with Hemophilia A and 95 healthy subjects matched for age and gender were enrolled in the study. The identification of B19V DNA was achieved using the real-time polymerase chain reaction (PCR). Hepatitis C virus (HCV) antibodies and hepatitis B surface antigen (HBsAg.) were tested by ELISA method. RESULTS: The frequency of B19V among hemophilia A patients was 13.7% compared to 6.3% among healthy subjects. None of the control group has been tested positive for HCV antibodies or HBsAg. While among patients, the frequencies of hepatitis C and B were 8.4% and 2.1%, respectively. Patients with hemophilia A and B19V have significantly higher rate of arthropathy at the time of blood sampling and blood and/blood products transfusion, especially fresh-frozen plasma (FFP) and cryoprecipitate compared to those who did not receive such blood products (92.3% vs. 50%), P < 0.05. CONCLUSIONS: Parvovirus B19 was detected in a significant proportion of hemophilia patients especially those with a history of FFP and cryoprecipitate transfusion. The use of PCR technique is essential to detect viruses in donor's blood to avoid infection among this high-risk group.
{"title":"Human parvovirus B19 among hemophilia A patients in Basrah, Southern Iraq","authors":"Murtadha A. Al‑khegane, W. Ibrahim, M. Hassan","doi":"10.4103/ijh.ijh_16_21","DOIUrl":"https://doi.org/10.4103/ijh.ijh_16_21","url":null,"abstract":"BACKGROUND: Hemophilia A patients, especially if there is shortage in recombinant Factor VIII concentrate, may require occasional blood and/blood products transfusion, rendering them more susceptible to acquire infections including Parvo B19 virus (B19V). OBJECTIVES: To assess the presence of B19V viral DNA among hemophilia A patients and look for its possible association with disease-related variables. SUBJECTS AND METHODS: This case–control study was carried out from October 2019 to August 2020. A total of 95 male patients with Hemophilia A and 95 healthy subjects matched for age and gender were enrolled in the study. The identification of B19V DNA was achieved using the real-time polymerase chain reaction (PCR). Hepatitis C virus (HCV) antibodies and hepatitis B surface antigen (HBsAg.) were tested by ELISA method. RESULTS: The frequency of B19V among hemophilia A patients was 13.7% compared to 6.3% among healthy subjects. None of the control group has been tested positive for HCV antibodies or HBsAg. While among patients, the frequencies of hepatitis C and B were 8.4% and 2.1%, respectively. Patients with hemophilia A and B19V have significantly higher rate of arthropathy at the time of blood sampling and blood and/blood products transfusion, especially fresh-frozen plasma (FFP) and cryoprecipitate compared to those who did not receive such blood products (92.3% vs. 50%), P < 0.05. CONCLUSIONS: Parvovirus B19 was detected in a significant proportion of hemophilia patients especially those with a history of FFP and cryoprecipitate transfusion. The use of PCR technique is essential to detect viruses in donor's blood to avoid infection among this high-risk group.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"112 - 117"},"PeriodicalIF":0.1,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42261510","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}
Selective serotonin reuptake inhibitors are commonly used in the treatment of many psychiatric diseases today. Their common side effects consist of gastrointestinal side effects, sexual dysfunction, headache, insomnia, and sedation, whereas hematological side effects have been reported, although rarely. In this article, we presented a case of thrombocytopenia, which is a rare side effect emerging after the escitalopram use, belonging to a 19-year-old female patient who had a generalized anxiety disorder and no hematological history was noted. We aimed to discuss the development mechanism of thrombocytopenia due to the escitalopram use.
{"title":"Thrombocytopenia due to escitalopram use – A rare case report at the emergency department","authors":"C. Bedel, M. Korkut","doi":"10.4103/ijh.ijh_47_20","DOIUrl":"https://doi.org/10.4103/ijh.ijh_47_20","url":null,"abstract":"Selective serotonin reuptake inhibitors are commonly used in the treatment of many psychiatric diseases today. Their common side effects consist of gastrointestinal side effects, sexual dysfunction, headache, insomnia, and sedation, whereas hematological side effects have been reported, although rarely. In this article, we presented a case of thrombocytopenia, which is a rare side effect emerging after the escitalopram use, belonging to a 19-year-old female patient who had a generalized anxiety disorder and no hematological history was noted. We aimed to discuss the development mechanism of thrombocytopenia due to the escitalopram use.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"10 1","pages":"79 - 81"},"PeriodicalIF":0.1,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48520125","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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