Asian Journal of Transfusion Science最新文献

{"title":"Emergency therapeutic leukapheresis: A single-center experience in a teaching hospital in Eastern India.","authors":"Girijanandini Kanungo, M Karthick, A Sharanya, Dattatreya Kar","doi":"10.4103/ajts.ajts_88_24","DOIUrl":"10.4103/ajts.ajts_88_24","url":null,"abstract":"<p><p>Hyperleukocytosis is a hematologic crisis caused by excessive proliferation of leukemic cells and has a relatively high early mortality due to a series of severe complications needing prompt and effective interventions. Leukapheresis performed using apheresis equipment to separate leukocytes from peripheral blood at the same time returns autologous plasma, platelets and erythrocytes to the patient and is applied clinically for treatment of hyperleukocytosis with symptoms of leukostasis. The aim of this study is to analyze the safety and effectiveness of therapeutic leukocytapheresis to alleviate symptoms of leukostasis in different types of hematological malignancies. The study is a retrospective review of procedures carried out for the treatment of hyperleukocytosis with symptoms of leukostasis at the Haematology Intensive Care Unit (ICU) and Critical Care ICU by the Transfusion Medicine Department of the institute from February 2019 to April 2024. Eleven patients underwent a total of 12 leukocytapheresis procedures. After an average of 1.09 sessions, a statistically significant drop in the initial leukocyte counts was observed (P = 0.0004), without any significant drop in Hemoglobin g% (P = 0.27%), hematocrit (P = 0.9%) and total platelet count (P = 0.15%). Despite the small size and limited homogeneity of our study, we can conclude that leukocytapheresis is a safe and effective adjuvant therapeutic measure for hematological malignancies, particularly acute lymphoid/myeloid leukemia, chronic myeloid leukemia with hyperleukocytosis and symptoms of leukostasis, especially in a patient who was not appropriate to cytoreduce with Ara-C or hydroxyurea.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"253-257"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor harvest of peripheral blood stem cells in donor with thalassemia trait.","authors":"Anju Radhakrishna Kurup, Mohandoss Murugesan, Chandran K Nair, Vineetha Raghavan, Sangeetha Keloth Nayanar","doi":"10.4103/ajts.ajts_91_24","DOIUrl":"10.4103/ajts.ajts_91_24","url":null,"abstract":"<p><p>Here, we present a case report detailing a failed harvest from a 3-year-old child, a sibling-matched related donor for a patient with thalassemia undergoing ABO-incompatible hematopoietic stem cell transplant. The initial apheresis procedure, with the donor having an hematocrit of 29.4 and a peripheral blood CD34 count of 72 cells/µl, resulted in a poor harvest, exhibiting an inadequate collection efficiency of 21% for the apheresis procedure. We here analyzed the factors that overt red cell abnormalities (low mean corpuscular volume [MCV]) in donor may account for failures to collect the circulating CD34+ cells by standard apheresis variables despite adequate mobilization. Individuals with low MCV who are at risk of stem cells harvest failure can be identified prior to apheresis, and poor harvest can be avoided by adjustment of the apheresis variable.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"228-231"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rotational thromboelastometry analysis of recovered plasma stored for a long period of time.","authors":"Ifigeneia Vasiliki Kontoteza, Marianna Politou, Georgios Dryllis, Abraham Pouliakis, Konstantinos Nikitiadis, Konstantinos Stamoulis","doi":"10.4103/ajts.ajts_56_24","DOIUrl":"10.4103/ajts.ajts_56_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although factor VIII (FVIII) is the marker of quality assurance of fresh-frozen plasma (FFP), global tests of coagulation could more accurately reflect the hemostatic profile of FFP. We aimed to evaluate the hemostatic potential of recovered plasma using rotational thromboelastometry and to correlate it with plasma's FVIII activity.</p><p><strong>Materials and methods: </strong>A total of 60 units of recovered plasma stored at-30°C for 11 years (12 units), 7 years (18 units), 3 years (17 units), and 2 years (13 units), were studied using thromboelastometry (ROTEM®, Munich, Germany) without accelerating activators (NATEM assay), a global assay, that evaluates viscoelastic properties during clot formation and lysis. ROTEM results were correlated with FVIII activity. The statistical analysis was performed using the SAS for Windows 9.4 software platform (SAS Institute Inc., NC, U.S.A.).</p><p><strong>Results: </strong>Despite the reduction of FVIII, most ROTEM parameters were within normal range (83%, 73%, 76% of plasma units had a normal clotting time, clot formation time and a angle value, respectively, and 100% of plasma units had a normal Lysis Index 30 [LI30] and LI 60 value) regardless of storage time.</p><p><strong>Conclusion: </strong>If confirmed in further studies, global methods of coagulation such as thromboelastometry, could assess the hemostatic potential of recovered plasma more precisely.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"180-183"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adsorption and elution study detected misidentification of para-Bombay phenotype donor in an incompatible crossmatch with Bombay phenotype patient.","authors":"Kella Nivedita, Somnath Mukherjee, Satya Prakash, Ansuman Sahu, Debasish Mishra","doi":"10.4103/ajts.ajts_86_23","DOIUrl":"10.4103/ajts.ajts_86_23","url":null,"abstract":"<p><p>Bombay and para-Bombay are rare phenotypes with H antigen-deficient red blood cells. A 54-year-old male patient suffering from suspected malignant pleural effusion was planned for thoracotomy. The patient's blood group showed blood group discrepancy during pretransfusion testing due to ABO isoagglutinin. Further workup with anti-H lectin was negative with pan-reactive antibody screening and negative autocontrol, which suggested that the patient is Bombay RhD positive. A known Bombay phenotype donor was called for donation. That Bombay donor is a para-Bombay donor incorrectly labeled as Bombay in another hospital. During pretransfusion testing, there was an incompatible crossmatch. Hence, the adsorption of donor red cells with the patient's serum was performed, followed by heat elution. The eluate was pan-reactive with an antibody screening panel indicating anti-H present. The Lewis phenotype of the donor is Leb positive, which reflects the secretor status of the individual. This case highlights the importance of reverse grouping, adsorption, Lewis phenotyping, and elution testing in detecting and differentiating Bombay and para-Bombay phenotypes to avoid fatal adverse transfusion events.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"249-252"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A whistleblower direct antiglobulin test in chronic kidney disease: An interesting case of occult autoimmune hemolytic anemia in an undiagnosed lymphoma with pure red cell aplasia.","authors":"Rasika Dhawan Setia, Mitu Dogra, Kunal Jain","doi":"10.4103/ajts.ajts_122_24","DOIUrl":"10.4103/ajts.ajts_122_24","url":null,"abstract":"<p><p>A 67-year-old male, presented with urosepsis, severe anemia, advancing azotemia requiring blood transfusion. Patient grouped as O RhD positive. Antibody screening was pan-positive (4+). Similar strong pan-positivity seen on antibody identification with extended cell panel. DAT was 4+ positive for IgG and negative for complement C3. Repeated identification with eluate also showed pan-positive (4+) reaction. Serum haptoglobin markedly reduced. Bone marrow aspirate suggested pure red cell aplasia with suspicion of parvovirus-related changes. Bone marrow biopsy suggested T-cell lymphoproliferative disorder. Immunophenotyping elucidated a suspicious clone of CD7-negative T-cells with CD4 restriction. Histopathological examination revealed angioimmunoblastic T-cell lymphoma (AITL) with bystander Epstein-Barr virus-driven large B-cells. Owing to rarity and nonspecific symptoms, diagnosis of AITL is often challenging. Antibody screen acted as a whistleblower for an undiagnosed aggressive lymphoma. Thus, it will be prudent to look beyond the obvious in complex cases, and a detailed workup will help put together all parts of the jigsaw puzzle.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"203-207"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of oral calcium to prevent citrate-related toxicity during peripheral blood hematopoietic stem cell collection - An experience from a tertiary care center.","authors":"Dibyajyoti Sahoo, Shahida Noushad, Abhishekh Basavarajegowda","doi":"10.4103/ajts.ajts_232_23","DOIUrl":"10.4103/ajts.ajts_232_23","url":null,"abstract":"<p><strong>Background: </strong>Apheresis procedures use citrate as an anticoagulant to ensure the fluidity of extracorporeal blood. Citrate-related toxicities are common adverse effects in peripheral blood stem cell (PBSC) collections as they are lengthy procedures resulting in prolonged citrate exposure. Intravenous (IV) calcium administration during therapeutic apheresis procedures is commonly used to reduce the citrate-related toxicity in adults and pediatric population. Very few literature on the use of oral calcium for the prevention of citrate toxicity during PBSC collection are present.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the effect of prophylactic oral calcium in reducing citrate-related toxicities during PBSC collections.</p><p><strong>Materials and methods: </strong>A prospective cross-sectional study was carried out at a tertiary care hospital of Southern India. All participants received calcium carbonate - 1 g before and at each 100 ml of collection. Preprocedure, interim, and postprocedure serum calcium were measured. All procedures were done using Spectra Optia. The ACD (acid-citrate-dextrose) rate were between 1:8 to 1:14 and were adjusted for inlet draw rate. The total blood volume processed between 2.5 to 3 based on body weight. Reduction in calcium levels and adverse reactions due to hypocalcemia were observed. Data were analyzed using SPSS 23 software.</p><p><strong>Results: </strong>The majority of the procedures were undisturbed and tolerable to oral calcium. A total of 97.3% of the study subjects did not experience any symptoms of hypocalcemia. Only 2.7% (One autologous and one allogenic donor) had symptoms attributable to hypocalcemia though they had preprocedure calcium >9 mg/dl. Pre- and postprocedure calcium were compared using a paired <i>t</i>-test which was statistically significant.</p><p><strong>Conclusion: </strong>Prophylactic oral calcium in PBSC collection is an effective and easy way to the prevention of citrate-related adverse effects without affecting technical performance and product efficacy.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"106-112"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thromboelastographic insights into hemostatic alterations in coronavirus disease 2019 (COVID-19) patients.","authors":"Anupam Verma, Indranil Das, Hemlata, Priti Elhence, Pallavi Rani, Awale Rupali Bhalchandra","doi":"10.4103/ajts.ajts_133_24","DOIUrl":"10.4103/ajts.ajts_133_24","url":null,"abstract":"<p><strong>Introduction: </strong>The coronavirus disease 2019 (COVID-19) has been shown to be a systemic disease affecting different organs of the body including hemostatic system. We aimed to see the utility of thromboelastography (TEG), a global viscoelastic test, in assessing hemostatic profile in COVID-19 patients.</p><p><strong>Methods: </strong>Laboratory records and relevant clinical profiles of our hospitalized COVID-19 patients who underwent TEG testing over a 1-year period were retrospectively studied.</p><p><strong>Results: </strong>Out of 103 patients analyzed hypercoagulability was observed on TEG in 49 (48%) patients which was due to hyperfibrinogenemia with hypofibrinolysis and it persisted till 32-56 days in a subset of recovered patients. Patients with hypercoagulable profile had higher clotting index (CI), maximum amplitude (MA), α-angle and lower <i>K</i> values, which correlated with plasma fibrinogen levels and platelet counts. Hypocoagulable TEG profile was observed in 10 (9%) patients out of which, seven had platelet hypocoagulability and three had plasmatic hypocoagulability. Those with hypocoagulable profile had statistically significant lower platelet counts, higher values of <i>R</i> and <i>K</i>, and lower values of angle, MA, and CI. Two patients with thrombocytopenia and normocoagulable TEG tracing had co-infection with dengue virus. Lesser recovery rate was observed in patients with hypocoagulable profile compared to those with hypercoagulable and normocoagulable profiles.</p><p><strong>Conclusion: </strong>The present study confirmed significant hypercoagulability on TEG in almost half of the patients with COVID-19 despite anticoagulant therapy which was not detectable by conventional coagulation tests. It is plausible that the initial presentation for most of COVID-19 patients was that of hypercoagulable profile which eventually progressed to a hypocoagulable profile in a subset of patients with poorer prognosis.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"43-49"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic plasma exchange for the management of hypertriglyceridemia-induced acute pancreatitis.","authors":"Do Thanh Hoa, Nguyen Gia Binh, Le Thi Viet Hoa, Nguyen Hai Ghi, Le Xuan Duong","doi":"10.4103/ajts.ajts_67_21","DOIUrl":"10.4103/ajts.ajts_67_21","url":null,"abstract":"<p><strong>Background: </strong>Hypertriglyceridemia (HTG) is the third-most important cause of acute pancreatitis (AP) and its early diagnosis is essential to prevent AP-associated morbidity and mortality. Therapeutic plasma exchange (TPE) is a promising treatment option for improving patient outcomes and prognosis in HTG-induced AP (HTG-AP).</p><p><strong>Objective: </strong>This study assessed the severity of disease in patients with HTG-AP and evaluated the therapeutic effects, safety, and procedural challenges of TPE in its management.</p><p><strong>Methods: </strong>Patients with HTG-AP, diagnosed according to the Atlanta classification, and exhibiting serum triglyceride (TG) concentrations ≥11.3 mmol/L were included in the study. Consenting patients received TPE using the PRISMAFLEX^® system (TPE group), and the remaining were treated in accordance with the guidelines of Vietnam's Ministry of Health, 2015 (non-TPE group). The duration of hospital or intensive care unit (ICU) stay in patients and mortality rates were compared between the TPE and non-TPE groups. The reduction in serum TG levels was also evaluated in the TPE group.</p><p><strong>Results: </strong>This prospective study included 165 patients with HTG-AP (<i>n</i> = 83, TPE group; <i>n</i> = 82, non-TPE group). The mean age of the patients was 41.0 ± 9.3 years. The duration of hospital and ICU stay was significantly lower in the TPE group compared to that of the non-TPE group (<i>P</i> < 0.05). A significant reduction in TG levels over baseline was noted in patients who received TPE (77%; <i>P</i> < 0.05), which was observed after the first TPE session (70.81%; <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>TPE using the PRISMAFLEX^® system is safe and well-tolerated in patients with HTG-AP and is associated with minimal technical constraints.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"8 1","pages":"98-105"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74418181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study to assess the levels of free protein S in pregnant and nonpregnant women in a tertiary care center in Western Maharashtra.","authors":"Neerja Kushwaha, Amit Kumar Biswas, Ajay Kumar Baranwal, Bidhan Roy, Amit Ajay Pawar, Ujjwal Dimri, Sujay Bhowmik","doi":"10.4103/ajts.ajts_155_22","DOIUrl":"10.4103/ajts.ajts_155_22","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is a hypercoagulable state increasing the risk of thrombosis and maternal mortality. Free protein S (FPS) levels are significantly reduced during pregnancy as compared to nonpregnant women. This study aims to ascertain the mean FPS levels for Indian pregnant women and study various factors like age, parity, trimester, hemoglobin (Hb) in relation to FPS.</p><p><strong>Materials and methods: </strong>521 pregnant and equal number of nonpregnant women were included in the study. Blood samples were collected and evaluated for FPS and Hb levels. <i>P</i> < 0.05 was considered statically significant.</p><p><strong>Results: </strong>Mean FPS levels in pregnant women were significantly lower than nonpregnant women and showed a statistically significant fall in all the three trimesters. Mean Hb levels were also lower in pregnant females however correlation between FPS levels and Hb, age, and parity were not found to be significant.</p><p><strong>Conclusion: </strong>This study found that the mean FPS levels in healthy pregnant females decrease with increasing gestational age. The mean FPS levels will be useful in the Indian scenario as our study found FPS levels to be much lower than other studies.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"92-97"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact dermatitis to a topical formulation of heparin in a blood donor.","authors":"Sreethu Chand, R S Mallhi, Joseph Philip","doi":"10.4103/ajts.ajts_124_23","DOIUrl":"10.4103/ajts.ajts_124_23","url":null,"abstract":"<p><p>Contact dermatitis is an inflammatory reaction to an irritant or allergen coming in contact with the skin. In this report, the authors present a case of contact dermatitis in a blood donor, which developed in response to the application of a topical heparin formulation. Topical heparin preparations are regularly used in blood centers for the resolution of hematomas associated with phlebotomy. Blood center personnel must be aware of this possible adverse effect that can add to the discomfort in a donor and use these preparations cautiously.</p>","PeriodicalId":42296,"journal":{"name":"Asian Journal of Transfusion Science","volume":"20 1","pages":"243-245"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}