Transfusion Medicine and Hemotherapy最新文献

{"title":"Impact of Clinical Parameters and Induction Regimens on Peripheral Blood Stem-Cell Mobilization and Collection in Multiple Myeloma Patients.","authors":"Sandra Sauer,&nbsp;Lennart Hieke,&nbsp;Juliane Brandt,&nbsp;Carsten Müller-Tidow,&nbsp;Anita Schmitt,&nbsp;Joseph Kauer,&nbsp;Katharina Kriegsmann","doi":"10.1159/000530056","DOIUrl":"https://doi.org/10.1159/000530056","url":null,"abstract":"<p><strong>Introduction: </strong>High-dose chemotherapy (HDCT) followed by autologous blood stem-cell transplantation (ABSCT) remains the standard consolidation therapy for newly diagnosed eligible multiple myeloma (MM) patients. As a prerequisite, peripheral blood stem cells (PBSCs) must be mobilized and collected by leukapheresis (LP). Many factors can hamper PBSC mobilization/collection. Here, we provide a comprehensive multiparametric assessment of PBSC mobilization/collection outcome parameters in a large cohort.</p><p><strong>Methods: </strong>In total, 790 MM patients (471 [60%] male, 319 [40%] female) who underwent PBSC mobilization/collection during first-line treatment were included. Evaluated PBSC mobilization/collection outcome parameters included the prolongation of PBSC mobilization, plerixafor administration, number of LP sessions, and overall PBSC collection goal/result.</p><p><strong>Results: </strong>741 (94%) patients received cyclophosphamide/adriamycin/dexamethasone (CAD) and granulocyte-colony-stimulating factor (G-CSF) mobilization. Plerixafor was administered in 80 (10%) patients. 489 (62%) patients started LP without delay. 530 (67%) patients reached the PBSC collection goal at the first LP session. The mean overall PBSC collection result was 10.3 (standard deviation [SD] 4.4) × 10⁶ CD34⁺ cells/kg. In a multiparametric analysis, variables negatively associated with PBSC mobilization/collection outcomes were female gender, age >60 years, an advanced ISS stage, and local radiation pre-/during induction, but not remission status postinduction. Notably, the identified risk factors contributed differently to each PBSC mobilization/collection outcome parameter. In this context, compared to all other induction regimens, lenalidomide-based induction with/without antibodies negatively affected only the number of LP sessions required to reach the collection goal, but no other PBSC mobilization/collection outcome parameters. In contrast, the probability of reaching a high collection goal of ≥6 × 10⁶ CD34⁺ cells/kg body weight was higher after lenalidomide-based induction compared to VCD/PAD or VAD - taking into account - that a higher G-SCF dosage was given in approximately one-third of patients receiving lenalidomide-based induction with/without antibodies.</p><p><strong>Conclusion: </strong>Considering the identified risk factors in the clinical setting can contribute to optimized PBSC mobilization/collection. Moreover, our study demonstrates the necessity for a differentiated evaluation of PBSC mobilization/collection outcome parameters.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 5","pages":"382-395"},"PeriodicalIF":2.2,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Digital Transformation on Blood Donation and Donor Characteristics.","authors":"Norbert Niklas, Claudia Loimayr, Julia Lenz, Susanne Süßner, Gerhard Schuster, David Jungwirth, Werner Watzinger, Stephan Federsel","doi":"10.1159/000530270","DOIUrl":"https://doi.org/10.1159/000530270","url":null,"abstract":"<p><strong>Introduction: </strong>The management of an adequate donor pool is a constant and challenging task for blood centers in order to provide blood supply. New methods are required to streamline processes and attract (new) donors on a sustained basis. We present a digitalization method without media disruption and show the impact on our donors and their behavior.</p><p><strong>Methods: </strong>We designed and created a blood donation app that is fully compliant to all regulations and conforms to donor expectations. The presented digitalization serves the donor from preparation before the donation (health questionnaire) until completion of laboratory testing (medical report). Many other features are included and continuously attract donors to engage with the blood donation topic.</p><p><strong>Results: </strong>Eighteen months after the launch of our app, there are already 45,000 users. The digital questionnaire reduced the number of deferrals by 31.9% compared to the conventional paper questionnaire. Digital adopters show a significantly shorter donation interval (193 days compared to 316 days). In-app incentives include identification card, rapid laboratory testing results (time-to-results are two business days for 95%), and collection of badges among others.</p><p><strong>Conclusion: </strong>The presented method has changed our donor pool. Besides that, medical staff benefits from the automated process that allows focusing on the donor and their admission. On the other hand, the app has become a valid tool to manage our donor pool and attract first-time and young donors.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 6","pages":"531-538"},"PeriodicalIF":2.2,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138807634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Expression Profiles of Exosomal circRNAs from Apheresis Platelets during Storage.","authors":"Jingfu Liu, Shan Chen, Zhen Li, Rong Lu, Xianren Ye","doi":"10.1159/000530040","DOIUrl":"https://doi.org/10.1159/000530040","url":null,"abstract":"<p><strong>Introduction: </strong>Bioactive substances of stored platelets change during the stored periods. Exosomes are reported to be increased during platelet storage. Circular RNAs (circRNAs) are one of the main components in exosomes. It is the purpose of this study to investigate the different expression of exosomal circRNAs during storage.</p><p><strong>Methods: </strong>Apheresis platelets were collected from 7 healthy volunteers and stored in platelet storage bags for 1 day or 5 days. We isolated exosomes by ultracentrifugation and characterized exosomes by transmission electron microscopy, nano-flow cytometry, and Western blot. We conducted microarray analysis to detect changes in the exosomal circRNAs from apheresis platelets during storage, and qRT-PCR to validate their expressions. To analyze the competing endogenous RNA (ceRNA) of circRNAs, microRNAs (miRNAs) targets were predicted based on interactions of circRNAs/miRNAs and miRNAs/mRNAs, using TargetScan and miRanda. A ceRNA network was constructed by Cytoscape. The targeted mRNAs were performed for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genome (KEGG) pathway analysis by the DAVID.</p><p><strong>Results: </strong>Microarray analysis revealed that 61 differentially expressed circRNAs between day 1 and day 5. Thirty-one circRNAs of these are upregulated, while 30 circRNAs are downregulated. A ceRNA visualized network includes 9 circRNAs, 48 miRNAs, and 117 mRNAs. There were 117 mRNAs enriched in 203 GO terms and 9 KEGG pathways based on the GO and KEGG pathway enrichment analyses.</p><p><strong>Conclusion: </strong>We identified 61 dysregulated exosomal circRNAs from apheresis platelets during storage. The study provided insights into the underlying mechanisms of platelet storage lesion.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 6","pages":"515-524"},"PeriodicalIF":2.2,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138807461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Current Patterns of Blood Product Use during Intensive Induction Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia Patients.","authors":"Liron Miller,&nbsp;Mor Freed-Freundlich,&nbsp;Avichai Shimoni,&nbsp;Tamer Hellou,&nbsp;Abraham Avigdor,&nbsp;Mudi Misgav,&nbsp;Jonathan Canaani","doi":"10.1159/000529595","DOIUrl":"https://doi.org/10.1159/000529595","url":null,"abstract":"<p><strong>Introduction: </strong>Blood product transfusion retains a critical role in the supportive care of patients with acute myeloid leukemia (AML). Whereas previous studies have shown increased transfusion dependency to portend inferior outcome, predictive factors of an increased transfusion burden and the prognostic impact of transfusion support have not been assessed recently.</p><p><strong>Methods/patients: </strong>We performed a retrospective analysis on a recent cohort of patients given intensive induction chemotherapy in 2014-2022.</p><p><strong>Results: </strong>The analysis comprised 180 patients with a median age of 57 years with 80% designated as de novo AML. Fifty-four patients (31%) were <i>FLT3-ITD</i> mutated, and 73 patients (42%) harbored <i>NPM1</i>. Favorable risk and intermediate risk ELN 2017 patients accounted for 43% and 34% of patients, respectively. The median number of red blood cell (RBC) and platelet units given during induction were 9 and 7 units, respectively. Seventeen patients (9%) received cryoprecipitate, and fresh frozen plasma (FFP) was given to 12 patients (7%). Lower initial hemoglobin and platelet levels were predictive of increased use of RBC (<i>p</i> < 0.0001) and platelet transfusions (<i>p</i> < 0.0001). FFP was significantly associated with induction related mortality (42% vs. 5%; <i>p</i> < 0.0001) and with <i>FLT3-ITD</i> (72% vs. 28%; <i>p</i> = 0.004). Blood group AB experienced improved mean overall survival compared to blood group O patients (4.1 years vs. 2.8 years; <i>p</i> = 0.025). In multivariate analysis, increased number of FFP (hazard ratio [HR], 4.23; 95% confidence interval [CI], 2.1-8.6; <i>p</i> < 0.001) and RBC units (HR, 1.8; 95% CI, 1.2-2.8; <i>p</i> = 0.008) given was associated with inferior survival.</p><p><strong>Conclusion: </strong>Transfusion needs during induction crucially impact the clinical trajectory of AML patients.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 5","pages":"456-468"},"PeriodicalIF":2.2,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Iron in Patients with Sickle Cell Disease Mediates the Release of Neutrophil Extracellular Traps.","authors":"Kristof Van Avondt,&nbsp;Marein Schimmel,&nbsp;Ingrid Bulder,&nbsp;Gerard van Mierlo,&nbsp;Erfan Nur,&nbsp;Robin van Bruggen,&nbsp;Bart J Biemond,&nbsp;Brenda M Luken,&nbsp;Sacha Zeerleder","doi":"10.1159/000526760","DOIUrl":"https://doi.org/10.1159/000526760","url":null,"abstract":"<p><strong>Introduction: </strong>Neutrophils promote chronic inflammation and release neutrophil extracellular traps (NETs) that can drive inflammatory responses. Inflammation influences progression of sickle cell disease (SCD), and a role for NETs has been suggested in the onset of vaso-occlusive crisis (VOC). We aimed to identify factors in the circulation of these patients that provoke NET release, with a focus on triggers associated with hemolysis.</p><p><strong>Methods: </strong>Paired serum and plasma samples during VOC and steady state of 18 SCD patients (HbSS/HbSβ⁰-thal and HbSC/HbSβ⁺-thal) were collected. Cell-free heme, hemopexin, and labile plasma iron have been measured in the plasma samples of the SCD patients. NETs formation by human neutrophils from healthy donors induced by serum of SCD patients was studied using confocal microscopy and staining for extracellular DNA using Sytox, followed by quantification of surface coverage using ImageJ.</p><p><strong>Results: </strong>Eighteen patients paired samples obtained during VOC and steady state were available (11 HbSS/HbSβ⁰-thal and 7 HbSC/HbSβ⁺-thal). We observed high levels of systemic heme and iron, concomitant with low levels of the heme-scavenger hemopexin in sera of patients with SCD, both during VOC and in steady state. In our in vitro experiments, neutrophils released NETs when exposed to sera from SCD patients. The release of NETs was associated with high levels of circulating iron in these sera. Although hemin triggered NET formation in vitro, addition of hemopexin to scavenge heme did not suppress NET release in SCD sera. By contrast, the iron scavengers deferoxamine and apotransferrin attenuated NET formation in a significant proportion of SCD sera.</p><p><strong>Discussion: </strong>Our results suggest that redox-active iron in the circulation of non-transfusion-dependent SCD patients activates neutrophils to release NETs, and hence, exerts a direct pro-inflammatory effect. Thus, we propose that chelation of iron requires further investigation as a therapeutic strategy in SCD.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 4","pages":"321-329"},"PeriodicalIF":2.2,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/b0/tmh-0050-0321.PMC10521246.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41130382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Individual Patient Platelet Demand in a Large Tertiary Care Hospital Using Machine Learning.","authors":"Merlin Engelke, Christian Martin Brieske, Vicky Parmar, Nils Flaschel, Anisa Kureishi, Rene Hosch, Sven Koitka, Cynthia Sabrina Schmidt, Peter A Horn, Felix Nensa","doi":"10.1159/000528428","DOIUrl":"10.1159/000528428","url":null,"abstract":"<p><strong>Introduction: </strong>An increasing shortage of donor blood is expected, considering the demographic change in Germany. Due to the short shelf life and varying daily fluctuations in consumption, the storage of platelet concentrates (PCs) becomes challenging. This emphasizes the need for reliable prediction of needed PCs for the blood bank inventories. Therefore, the objective of this study was to evaluate multimodal data from multiple source systems within a hospital to predict the number of platelet transfusions in 3 days on a per-patient level.</p><p><strong>Methods: </strong>Data were collected from 25,190 (42% female and 58% male) patients between 2017 and 2021. For each patient, the number of received PCs, platelet count blood tests, drugs causing thrombocytopenia, acute platelet diseases, procedures, age, gender, and the period of a patient's hospital stay were collected. Two models were trained on samples using a sliding window of 7 days as input and a day 3 target. The model predicts whether a patient will be transfused 3 days in the future. The model was trained with an excessive hyperparameter search using patient-level repeated 5-fold cross-validation to optimize the average macro F2-score.</p><p><strong>Results: </strong>The trained models were tested on 5,022 unique patients. The best-performing model has a specificity of 0.99, a sensitivity of 0.37, an area under the precision-recall curve score of 0.45, an MCC score of 0.43, and an F1-score of 0.43. However, the model does not generalize well for cases when the need for a platelet transfusion is recognized.</p><p><strong>Conclusion: </strong>A patient AI-based platelet forecast could improve logistics management and reduce blood product waste. In this study, we build the first model to predict patient individual platelet demand. To the best of our knowledge, we are the first to introduce this approach. Our model predicts the need for platelet units for 3 days in the future. While sensitivity underperforms, specificity performs reliably. The model may be of clinical use as a pretest for potential patients needing a platelet transfusion within the next 3 days. As sensitivity needs to be improved, further studies should introduce deep learning and wider patient characterization to the methodological multimodal, multisource data approach. Furthermore, a hospital-wide consumption of PCs could be derived from individual predictions.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 4","pages":"277-285"},"PeriodicalIF":1.9,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/77/tmh-0050-0277.PMC10521242.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41148935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of Bone Marrow Necrosis following Severe Vaso-Occlusive Crisis in Patient with Compound Heterozygous Sickle Cell Disease.","authors":"Daniel N Marco,&nbsp;Joan Cid,&nbsp;Marta Garrote,&nbsp;Albert Cortés-Bullich,&nbsp;Ferran Seguí,&nbsp;Miquel Lozano","doi":"10.1159/000529500","DOIUrl":"https://doi.org/10.1159/000529500","url":null,"abstract":"<p><strong>Introduction: </strong>Bone marrow necrosis is a rare entity that can develop in context of a sickle cell disease vaso-occlusive crisis. Its physiopathology is related to an endothelial dysfunction taking place in bone marrow microvasculature.</p><p><strong>Case presentation: </strong>A 30-year-old patient with history of compound heterozygous sickle cell disease was admitted following SARS-CoV-2 infection with fever and diarrhea. After initial favorable evolution, he developed a severe vaso-occlusive crisis with intense hemolysis and multi-organ ischemic complications. Patient then developed high fever and hypoxemia. With the suspicion of acute thoracic syndrome, a red blood cell exchange was performed. Respiratory symptoms ceased but patient persisted febrile with very high levels of acute phase reactants, persistent pancytopenia, and leucoerythroblastic reaction. An infectious cause was ruled out. Afterward, bone marrow aspiration and bone marrow biopsy showed a picture of bone marrow necrosis, which is an extremely rare complication of vaso-occlusive crisis but, paradoxically, more frequent in milder heterozygote cases of sickle cell disease. Ultimately, large deposits of complement membrane attack complex (particles C5b-9) were demonstrated after incubation of laboratory endothelial cells with activated plasma from the patient.</p><p><strong>Discussion: </strong>The clinical presentation and findings are consistent with a case of bone marrow necrosis. In this setting, the demonstration of complement as a potential cause of the endothelial dysfunction mimics the pattern of atypical hemolytic uremic syndrome and other microangiopathic anemias. This dysregulation may be a potential therapeutic target for new complement activation blockers.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 4","pages":"360-364"},"PeriodicalIF":2.2,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/27/tmh-0050-0360.PMC10521221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Different Hemoglobin Levels on Near-Infrared Spectroscopy-Derived Cerebral Oxygen Saturation in Elderly Patients Undergoing Noncardiac Surgery.","authors":"Achilles Delis,&nbsp;Derek Bautz,&nbsp;Heidi Ehrentraut,&nbsp;Karin Doll,&nbsp;Thomas M Randau,&nbsp;Andreas C Strauss,&nbsp;Ivana Habicht,&nbsp;Erdem Güresir,&nbsp;Holger Bogatsch,&nbsp;Peter Kranke,&nbsp;Maria Wittmann,&nbsp;Patrick Meybohm,&nbsp;Markus Velten","doi":"10.1159/000528888","DOIUrl":"https://doi.org/10.1159/000528888","url":null,"abstract":"<p><strong>Background: </strong>Near-infrared spectroscopy (NIRS) is a commonly used technique to evaluate tissue oxygenation and prevent harmful cerebral desaturation in the perioperative setting. The aims of the present study were to assess whether surgery-related anemia can be detected via NIRS of cerebral oxygen saturation and to investigate the effects of different perioperative transfusion strategies on cerebral oxygenation, potentially affecting transfusion decision-making.</p><p><strong>Study design and methods: </strong>Data from the ongoing multicenter LIBERAL-Trial (liberal transfusion strategy to prevent mortality and anemia-associated ischemic events in elderly noncardiac surgical patients, LIBERAL) were used. In this single-center sub-study, regional cerebral oxygenation saturation (rSO₂) was evaluated by NIRS at baseline, pre-, and post-RBC transfusion. The obtained values were correlated with blood gas analysis-measured Hb concentrations.</p><p><strong>Results: </strong>rSO₂ correlated with Hb decline during surgery (<i>r</i> = 0.35, <i>p</i> < 0.0001). Different RBC transfusion strategies impacted rSO₂ such that higher Hb values resulted in higher rSO₂. Cerebral desaturation occurred at lower Hb values more often.</p><p><strong>Discussion: </strong>Cerebral oxygenation monitoring using NIRS provides noninvasive rapid and continuous information regarding perioperative alterations in Hb concentration without the utilization of patients' blood for blood sampling. Further investigations are required to demonstrate if cerebral rSO₂ may be included in future individualized transfusion decision strategies.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 4","pages":"270-276"},"PeriodicalIF":2.2,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/4c/tmh-0050-0270.PMC10521215.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41140565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Screening of Blood Donors for <i>Babesia</i> in Tyrol, Austria.","authors":"Evan M Bloch, Anita Siller, Laura Tonnetti, Steven J Drews, Bryan R Spencer, Doris Hedges, Tessa Mergenthal, Marijke Weber-Schehl, Manfred Astl, Eshan U Patel, Manfred Gaber, Harald Schennach","doi":"10.1159/000528793","DOIUrl":"10.1159/000528793","url":null,"abstract":"<p><strong>Introduction: </strong><i>Babesia</i> is a tick-borne intraerythrocytic parasite that is globally ubiquitous, yet understudied. Several species of <i>Babesia</i> have been shown to be transfusion-transmissible. <i>Babesia</i> has been reported in blood donors, animals, and ticks in the Tyrol (Western Austria), and regional cases of human babesiosis have been described. We sought to characterize the risk of <i>Babesia</i> to the local blood supply.</p><p><strong>Methods: </strong>Prospective molecular testing was performed on blood donors who presented to regional, mobile blood collection drives in the Tyrol, Austria (27 May to October 4, 2021). Testing was conducted using the cobas^® Babesia assay (Roche Molecular Systems, Inc.), a commercial PCR assay approved for blood donor screening that is capable of detecting the 4 primary species causing human babesiosis (i.e., <i>B. microti</i>, <i>B. divergens</i>, <i>B. duncani</i>, and <i>B. venatorum</i>). A confirmatory algorithm to manage initial PCR-reactive samples was developed, as were procedures for donor and product management.</p><p><strong>Results: </strong>A total of 7,972 donors were enrolled and screened; 4,311 (54.1%) were male, with a median age of 47 years (IQR = 34-55). No positive cases of <i>Babesia</i> were detected, corresponding with an overall prevalence of 0.00% (95% CI: 0.00%, 0.05%).</p><p><strong>Discussion: </strong>The findings suggest that the prevalence of <i>Babesia</i> is low in Austrian blood donors residing in the Tyrol, even during months of peak tick exposure. Although one cannot conclude the absence of <i>Babesia</i> in this population given the limited sample size, the findings suggest that the regional risk of transfusion-transmitted babesiosis is low.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 4","pages":"330-333"},"PeriodicalIF":2.2,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/d1/tmh-0050-0330.PMC10521223.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PharmaNews","authors":"","doi":"10.1159/000529216","DOIUrl":"https://doi.org/10.1159/000529216","url":null,"abstract":"«Mit dem Innovationsforum Schmerzmedizin der Deutschen Gesellschaft für Schmerzmedizin e.V. (DGS) geben wir insbesondere Allgemeinmedizinern, Internisten, Orthopäden, Neurologen, Anästhesisten und Schmerzmedizinern die Möglichkeit, ihr Fachwissen zu vertiefen und neue Impulse für ihre tägliche Arbeit zu erhalten», so DGS-Präsident Dr. Johannes Horlemann. Die Hämophilie ist ein neues Thema der jährlich stattfindenden Fortbildungsveranstaltung. «Schmerzen werden bei dieser seltenen Erkrankung unzureichend erfasst und behandelt. Darauf wollen wir aufmerksam machen», erklärte Horlemann. Bei der Hämophilie treten spontane innere Blutungen, meist in den Gelenken (80%) auf. Akute Schmerzen – verbunden mit Schwellungen und Bewegungseinschränkungen – sind die Folge. Wiederholte Blutungen können Entzündungsreaktionen, Knorpeldegenerationen und Gelenkdeformationen bedingen. Diese sogenannte hämophile Arthropathie kann wiederum zu chronischen Schmerzen führen. Mittels Prävention, Physiotherapie, Sport, Medikamenten, individueller Schmerztherapie oder auch mit einem chirurgischen Eingriff als letzte Option, lassen sich die Schmerzen wirksam behandeln. Durch eine prophylaktische Substitution von Gerinnungsfaktoren – angepasst an die Lebenssituation der Patient*innen – kann zudem das Auftreten der hämophilen Arthropathie deutlich verzögert und abgemildert werden. Horlemanns Appell: «Wir Schmerzmediziner sollten die Patient*innen niemals aufgeben, sondern uns intensiv um sie bemühen und intensiv mit Hämophiliebehandlern zusammenarbeiten.»","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"50 1","pages":"71 - 74"},"PeriodicalIF":2.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42519785","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}