Transfusion Medicine and Hemotherapy最新文献

{"title":"Association of Circulating Procoagulant Microvesicles with Painful Vaso-Occlusive Crisis in Sickle Cell Disease.","authors":"Akbar Hashemi Tayer, Reza Ranjbaran, Maryam Kamravan, Mojdeh Abbasi, Reyhaneh Zareian","doi":"10.1159/000525640","DOIUrl":"10.1159/000525640","url":null,"abstract":"<p><strong>Introduction: </strong>Thrombotic complication is one of the features of sickle cell disease (SCD), characterized by appearance of phosphatidylserine on the outer membrane of sickle-shaped red blood cells and most abundantly on membrane protrusions called microvesicles (MVs). However, the exact mechanism by which MVs may enhance coagulant activity in SCD patients has not been fully addressed. The aim of this study was to further investigate the procoagulant activity of circulating MVs in sickle cell crises.</p><p><strong>Materials and methods: </strong>Subjects included in this cross-sectional study were 47 patients with SCD and 25 normal subjects with written informed consent obtained from all the participants. MV analysis was conducted by using CD61, CD235α, and Annexin-V monoclonal antibodies. The coagulant activity of MVs was determined by an ELISA-based procoagulant activity assay.</p><p><strong>Results: </strong>The majority of MVs were originated from platelets (CD61+) and erythrocytes (CD235+). These MVs demonstrated significantly enhanced levels during the painful crisis when compared with the steady-state period (<i>p</i> < 0.001) and controls (<i>p</i> < 0.001). Also, the procoagulant activity of MVs was significantly higher in crisis compared to those of steady state (<i>p</i> < 0.001) and positively correlated with the number of Annexin-V+ MVs (<i>p</i> < 0.001). Significant correlations were found between erythrocyte-derived MVs with hemolysis marker (<i>r</i> = 0.51, <i>p</i> < 0.001) and the hemoglobin level (<i>r</i> = -0.63, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The numbers of platelet- and erythrocyte-derived MVs are related to painful crisis, and their quantification in SCD may be helpful for identifying cases at increased risk of thrombotic complications.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45238386","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":"Autologous Stem Cell Collection after Daratumumab, Bortezomib, Thalidomide, and Dexamethasone versus Bortezomib, Cyclophosphamide, and Dexamethasone in Newly Diagnosed Multiple Myeloma.","authors":"Sandra Sauer, Katharina Kriegsmann, Cathleen Nientiedt, Anita Schmitt, Carsten Müller-Tidow, Marc-Steffen Raab, Joseph Kauer","doi":"10.1159/000529691","DOIUrl":"10.1159/000529691","url":null,"abstract":"<p><strong>Introduction: </strong>In transplant-eligible, newly diagnosed multiple myeloma (NDMM) patients, autologous peripheral blood stem cell (PBSC) collection is usually pursued after induction therapy. While induction regimens are constantly refined regarding response, their impact on PBSC collection is not fully studied. The inclusion of the anti-CD38 antibody daratumumab into induction therapy significantly improved outcomes for patients with NDMM, e.g., as part of the daratumumab, bortezomib, thalidomide, and dexamethasone (Dara-VTD) protocol. Preliminary data from the phase 3 CASSIOPEIA study proved the efficacy of Dara-VTD. While overall PBSC collection upon addition of daratumumab was reduced in the study population, more detailed analyses on the impact are missing.</p><p><strong>Methods: </strong>We here report on PBSC mobilization and collection metrics in <i>n</i> = 119 patients with NDMM who underwent induction therapy with bortezomib, cyclophosphamide, and dexamethasone (VCD, <i>n</i> = 61) or Dara-VTD (<i>n</i> = 58).</p><p><strong>Results: </strong>Patient characteristics were well balanced between groups. The Dara-VTD group showed improved response parameters with 66% of patients reaching at least very good partial response versus 54% in the VCD group. Dara-VTD patients exhibited inferior mobilization metrics such as peripheral blood CD34⁺ cell count at the first leukapheresis (LP) session (65 vs. 106/μL, <i>p</i> = 0.001), median number of LP sessions (2 vs. 1, <i>p</i> = 0.001), and PBSC collection at first LP (5.5 vs. 8.3 × 10⁶/kg body weight [bw], <i>p</i> = 0.001). Utilization of plerixafor was slightly higher after Dara-VTD (33% vs. 21% of patients, <i>p</i> = 0.143). The overall PBSC collection result was significantly lower after Dara-VTD (8.4 vs. 9.6 × 10⁶/kg bw, <i>p</i> = 0.026). 78% and 85% of patients successfully collected 3 transplants with ≥2 × 10⁶ CD34⁺ cells/kg bw in the Dara-VTD and the VCD groups, respectively.</p><p><strong>Conclusion: </strong>In summary, Dara-VTD, possibly due to both anti-CD38 antibody and thalidomide exposure, imposes a limitation on PBSC collection which can be only partly overcome by utilization of plerixafor.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45885979","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":null,"pages":null},"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":null,"pages":null},"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":"How to Ensure Blood Supply and Blood Safety in the Future.","authors":"Peter Schlenke","doi":"10.1159/000529872","DOIUrl":"10.1159/000529872","url":null,"abstract":"","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/db/88/tmh-0050-0105.PMC10025364.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9289491","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":null,"pages":null},"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":"Success Rate and Long-Term Effects of Embolization of Pelvic Arteries for the Treatment of Postpartum Hemorrhage.","authors":"Elisabeth Kapfhammer,&nbsp;Thomas Pfammatter,&nbsp;Romana Brun,&nbsp;Roland Zimmermann,&nbsp;Christian Haslinger","doi":"10.1159/000527614","DOIUrl":"10.1159/000527614","url":null,"abstract":"<p><strong>Introduction: </strong>Postpartum hemorrhage (PPH) is the leading cause of peripartal maternal mortality and accounts for 25% of all maternal deaths worldwide. The most common reasons of PPH are uterine atony, retained placenta, or placenta accreta spectrum. Treatment of PPH depends on the etiology and corresponds to a stepwise approach, which follows the German, Austrian and Swiss guideline for the diagnosis and therapy of PPH in Switzerland. In severe ongoing PPH, hysterectomy has been the ultima ratio for many decades. Nowadays, interventional embolization of the pelvic arteries (PAE) has become a popular alternative. Besides being a highly effective minimally invasive method, PAE avoids hysterectomy with consecutively reduced morbidity and mortality. However, data on the long-term effects of PAE on fertility and menstrual cycle are scarce.</p><p><strong>Methods: </strong>We performed a monocentric study consisting of a retro- and a prospective part including all women who had undergone a PAE between 2012 and 2016 at University Hospital Zurich. Descriptive characteristics of patients and efficacy of PAE defined as cessation of bleeding were analyzed retrospectively. In the prospective part, all patients were contacted for a follow-up questionnaire regarding menstruation and fertility after embolization.</p><p><strong>Results: </strong>Twenty patients with PAE were evaluated. Our data showed a success rate of PAE in 95% of patients with PPH; only 1 patient needed a second, then successful, PAE. No patient needed a hysterectomy or any other surgical intervention. In our study, an association between mode of delivery and identified etiology of PPH is observed. After spontaneous delivery (<i>n</i> = 6), the main reason of severe PPH was retained placenta (<i>n</i> = 4), while after cesarean section (<i>n</i> = 14), uterine atony was identified in most cases (<i>n</i> = 8). Regarding menstruation after embolization, all women reported regular menstruation after the breastfeeding period (100%). The majority reported a regular pattern with a shorter or similar duration (73%) and lower or similar intensity (64%). Dysmenorrhea decreased in 67% of patients. Four patients planned another pregnancy, of whom only one had become pregnant with assisted reproductive technology and ended up in a miscarriage.</p><p><strong>Discussion: </strong>Our study confirms the efficacy of PAE in PPH, thus obviating complex surgical interventions and associated morbidity. The success of PAE does not depend on the primary cause of PPH. Our results may encourage the prompt decision to perform PAE in the management of severe PPH in case of failure of conservative management and help physicians in the post-interventional counseling regarding menstruation patterns and fertility.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10191223","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":null,"pages":null},"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":null,"pages":null},"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":"Successful Management of Severe Hyperhaemolysis with Combined Tocilizumab and Rituximab in Non-Transfusion-Dependent Thalassaemia: A Case Report.","authors":"Amal M El Afifi,&nbsp;Alia M Saeed,&nbsp;Gihad H Fekry,&nbsp;Mariam A Mostafa,&nbsp;Reham A Elmetwally,&nbsp;Inas M Hamed,&nbsp;Aliaa N Hussein,&nbsp;Gomaa M Hasanien","doi":"10.1159/000524743","DOIUrl":"https://doi.org/10.1159/000524743","url":null,"abstract":"<p><strong>Introduction: </strong>This is the fourth case reporting the administration of tocilizumab to control hyperhaemolysis. It was administered with rituximab to stop hyperhaemolysis refractory to frontline therapy. Hyperhaemolysis is a rare life-threatening subtype of delayed haemolytic transfusion reaction. Refractory cases pose a clinical challenge with no standard of care to date.</p><p><strong>Case presentation: </strong>A 29-year-old lady with non-transfusion-dependent thalassaemia presented with refractory hyperhaemolysis necessitating the administration of rituximab. This was complicated with anaemic heart failure and altered sensorium exacerbated with further transfusions. A nadir haemoglobin of 2.1 g/dL was reached after the initiation of rituximab, and her condition was too critical to wait for the slow expected improvement. Hence, tocilizumab was given as a bridging therapy to block haemolysis till the delayed onset of radical treatment.</p><p><strong>Conclusion: </strong>Tocilizumab can be effectively combined with rituximab to stop hyperhaemolytic episode refractory to first-line treatment when a prompt response is needed.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/4d/tmh-0050-0066.PMC9911996.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10763923","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}