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Ulrich Slaughter opublikował 1 rok, 8 miesięcy temu
With improvements in apheresis collection, platelet additive solution (PAS) is steadily replacing plasma as the storage medium in single donor platelets (SDP). Concentrating platelets in SDP with one-third of plasma and two-thirds of PAS is referred as Concentrated-SDP (C-SDP). We studied the influence of donor hematocrit (Hct) in C-SDP procedures. A retrospective study, consisting of 124 and 95 plateletpheresis donors in MCS+ and Trima respectively. We compared two apheresis equipments MCS+ and Trima with regard to donor hematocrit on procedural parameters such as collection efficiency (CE), collection rate (CR), yield per hour (Y/H), yield per litre (Y/L) and percentage blood volume processed (%BV) during C-SDP procedures. Donors were categorized into two groups with Group A (Hct ≤ 46%) and Group B (Hct > 46%) based on mean baseline Hct of the study population. Among the 219 procedures, the overall CE was significantly higher for Trima over MCS+ equipment (77 vs 56, P less then 0.001). However, there was no difference in procedural outcomes like CE, Y/L, Y/H, CR with MCS+ or Trima equipment between groups. %BV processed had a negative correlation with hematocrit in MCS+ (r = - 0.305, P = 0.001) and no difference was observed with Trima equipment. Donor Hct influences C-SDP collection only in processed blood volume with MCS+ equipment. Trima had statistically better performance over MCS+ equipments in all procedural parameters during C-SDP procedures. The data will guide apheresis centre to choose equipments based on donor characteristics. © Indian Society of Hematology and Blood Transfusion 2019.Anemia is a significant public health problem during pregnancy and its prevalence varies in different cohorts. Correct identification of this problem in a given population is important for implementation of various health schemes. This study was carried out at a tertiary care hospital in Haryana. The prevalence of anemia in females at the time pregnancy diagnosis during first trimester was studied. The study period was January 2018 to June 2019. Severity of anemia was categorized as mild (hemoglobin 10-10.9 gm/dl), moderate (hemoglobin 7-9.9 gm/dl) and severe (hemoglobin less then 7 gm/dl) as per the WHO definition. Relevant review of literature on prevalence of anemia in pregnancy in different Indian states was done. The median age of 388 females with diagnosis of pregnancy during first trimester was 27 years. Mean hemoglobin concentration was 10.47 gm/dl. 264 (68%) females had anemia. Out of these 191 (72.3%) had mild anemia, 65 (24.6%) had moderate anemia and eight had severe anemia. Out of the total study population, 270 (69.58%) were from rural and 118 (30.41%) were from urban background. Among the anemic pregnant females, 179 (67.8%) belonged to rural areas and 85 (32.20%) belonged to urban areas. Out of 264 patients with anemia, 87 (32.95%) patients were primigravida and 177 (67.04%) were multiparous females. The results of literature review showed a high prevalence of anemia in the other Indian states also. There is high prevalence of anemia in females at the time of diagnosis of pregnancy. Rates of anemia are higher in females with higher parity. © Indian Society of Hematology and Blood Transfusion 2019.HbE Beta thalassemia is phenotypically very diverse disease. We aim to study role of various genetic factors in determining severity of this disease. 243 diagnosed cases of HbE Beta thalassemia were included in this study. Patients were divided in two arms-transfusion dependent and non-transfusion dependent arms. Various factors (percentage of haemoglobin F, hemoglobin E, type of Beta mutation, Xmn1 polymorphism, alpha deletion, HPFH mutation) were evaluated in these patients. Xmn1 polymorphism (homozygous and heterozygous), presence of HPFH mutation and alpha deletion were more prevalent in NTDT arm versus TDT arm (p value less then 0.001). Higher prevelance of severe beta mutation IVS 1-5 (G → C) mutation 64(61.54%) vs 38(27.34); p value less then 0.001 was found in TDT arm when above factors were excluded from analysis. Higher mean haemoglobin F and mean Hemoglobin E percentage was associated with NTDT arm (p value less then 0.001). Various factors (hemoglobin F and E percentage, Xmn1 polymorphism, HPFH mutation, alpha deletion and IVS 1-5 Beta mutation) were identified to affect severity of this cohort. © Indian Society of Hematology and Blood Transfusion 2019.Hb E-Beta thalassemia is a disease with marked clinical diversity. In this study, phenotypic diversity of Hb E-β thalassemia children were analysed by studying the clinical and hematological parameters. This was a cross sectional study done in one and a half year period in the department of Pediatrics of a tertiary care teaching hospital. Participants were 62 Hb E-β thalassemic children of age group 1 month to 18 years coming to the Thalassemia day care centre for blood transfusion. Data collected from history, examination findings and investigation reports were analyzed. MF ratio was 1.071; 71% children were above 5 years of age. 90.3% children were Hindu. In 66.1% children, Hb level was below 5 gm/dl at the time of diagnosis. Mean HbF level was 32.6% ± 11.2. Stunting was seen in 64.5%. Average liver and spleen size were 2.5 and 4.4 cm respectively. Beside pallor, most common clinical findings were splenomegaly (93.5%), facial deformity (87%), dusky skin color (82.5%) and hepatomegaly (75.8%). 1.6% children were mild, 43.5% children were moderate and 54.8% children were of severe type. In our study there was no significant correlation between severity of the disease and HbF level (r = 0.0853, p = 0.0509). Age at the time of diagnosis, hemoglobin level at the time of first transfusion, age at receiving first blood transfusion, requirement of blood transfusion, spleen size and growth, are some factors affecting severity of the disease. But severity cannot be assessed by considering only one clinical or hematological parameter but by considering several parameters together. © Indian Society of Hematology and Blood Transfusion 2019.To describe the health-related quality of life (HRQoL) and fatigue burden among adult patients with immune thrombocytopenia (ITP) in China and determine whether they vary with disease phase. This is a cross-sectional, multi-centre observational study of adult ITP patients and the general population. Participants completed the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). We compared HRQoL and fatigue between ITP patients and the general population, overall and by disease phase (newly diagnosed, persistent, and chronic), using propensity score matching. 203 Patients and 269 members of the general population were recruited. Thirty-six ITP patients (17.7%) were newly diagnosed, 46 (22.7%) were persistent, and 121 (59.6%) were chronic. Compared with the general population, ITP patients had impaired HRQoL and greater fatigue burden. The persistent ITP group showed the largest number of SF-36 scales exceeding the minimally important difference physical functioning [- 10.5; 95% confidence interval (CI) - 24.5 to 3.5; P less then 0.001], role physical (- 16.7; 95% CI - 36.4 to 3.0; P less then 0.001), social functioning (- 15.6; 95% CI - 34.5 to 3.3; P less then 0.001), and role emotional (- 12.1; 95% CI - 26.0 to 1.8; P less then 0.001). Chronic ITP patients had the worst FACIT-F scores (36.89 ± 5.21). Higher fatigue severity was associated with lower physical and mental HRQoL. The HRQoL and fatigue burden of Chinese adult patients with ITP vary by disease phase. Persistent ITP patients were the most vulnerable subgroup in terms of HRQoL, while chronic ITP patients bear the heaviest fatigue burden. © Indian Society of Hematology and Blood Transfusion 2019.We performed a prospective multi-centre observational study to understand the incidence of IFI in patients with AML in India with use of anti-fungal prophylaxis. All patients with AML receiving either induction chemotherapy or salvage chemotherapy between November 2014 and February 2016 were included in this prospective observational study from 10 Indian centres. IFI was defined as per the revised EORTC-MSG criteria. Data on type of chemotherapy used, type of anti-fungal prophylaxis used, time to neutrophil recovery, incidence of IFI and survival were collected. Two hundred patients (118 male and 82 females) with a median age of 35 years (range 2-66) were recruited. One hundred and eighty-six (93%) had newly diagnosed acute myeloid leukemia (AML) while 14 (7%) had relapsed disease. IFI occurred in 53 patients (26.5%) with proven or probable IFI occurring in 17 (8.5%). Use of posaconazole prophylaxis (p = 0.027) was the only factor found to be associated with a reduced incidence of IFI. The overall survival (OS) at 6 weeks and 3 months respectively was similar among patients who had IFI (83.0 ± 5.2%; 81.0 ± 5.4%) as compared to those without IFI (84.4 + 3.0%; 81.4 ± 3.2%). This prospective study reveals a high incidence of IFI in patients undergoing chemotherapy for AML in India. The use of posaconazole prophylaxis was associated with a significantly lower incidence of IFI. Optimal strategies to prevent IFI need to be studied. © Indian Society of Hematology and Blood Transfusion 2019.Acute myelogenous leukemia (AML) is a heterogeneous disease characterized by myeloid progenitor cells uncontrolled proliferation gradually replacing normal hematopoiesis. To evaluate Ten Eleven Translocation 2 gene (TET2) single nucleotide polymorphism (SNP) (rs2454206, rs34402524, rs61744960) in AML, and chronic myeloid leukemia (CML) in relation to their disease prognostic criteria. The study included 136 subjects; 52 AML, 54 CML and 30 subjects as control group matched for age and sex. Routine investigations including CBC, bone marrow aspiration, flow cytometry biochemical investigations and cytogenetics and molecular study were performed accordingly. DNA extraction and SNP assay for TET2 gene polymorphism was done using (Thermo-Fisher predesigned SNP, USA) PCR prism 7500. The mean age was 43.4 ± 14.0 years in AML patients, 45.98 ± 15.7 years in CML patients and 39.3 ± 6.587 years in control group (p > 0.05). The frequency of TET2 SNP rs 34402524 ranged from heterozygous to homozygous in both AML (46%, 54%leukemogenesis transformation. © Indian Society of Hematology and Blood Transfusion 2019.Chronic lymphocytic leukemia (CLL) is a common hematological malignancy. This study is aimed to investigate the prognostic effect of clinic, laboratory and flow cytometric analysis in CLL patients. Newly diagnosed 55 CLL cases were divided into two groups, as stable disease (Group 1) and progressive disease (Group 2). Group 1 included those who did not require any treatment since diagnosis and those who did not progress after receiving the first step anti CLL treatment. Group 2 included the patients who received ≥ 2 steps treatment. The relation between the two groups was analyzed statistically in terms of clinical, laboratory and flow cytometric findings. Twenty patients (36.3%) required treatment at the time of diagnosis, four patients (3.8%) received first-line treatment during follow-up and 31 (56.3%) patients were followed without any treatment. Thirteen patients required second step treatment after a median of 26.3 months. The risk of progression was found to be increased 5-fold (p = 0.015) in the CD38 positive patient group, 4.


