Indian Journal of Hematology and Blood Transfusion最新文献

{"title":"Factors Influencing the Severity of Jaundice in Direct Antiglobulin (Coomb's) Test Positive Neonates.","authors":"T Rabiyathul Sanofar Nisha, Nidhya Ganesan, Prasanna N Kumar, Ramesh Srinivasan","doi":"10.1007/s12288-024-01871-2","DOIUrl":"10.1007/s12288-024-01871-2","url":null,"abstract":"<p><strong>Purpose: </strong>Direct Antiglobulin Test (DAT) is a screening method used to identify Hemolytic Diseases of Newborn (HDN). Risk of neonatal jaundice for infants with positive DAT is four times higher than those with negative DAT. However, clinical guidelines regarding the risk factors amongst DAT positive neonates requiring phototherapy are not clear. This study aimed to assess the risk factors that influence the severity of jaundice among DAT positive neonates and its impact on treatment.</p><p><strong>Methods: </strong>A one-year retrospective observational study (2022-2023) which included all DAT- positive newborn babies reported in that period.</p><p><strong>Results: </strong>In our study period 134 babies had jaundice and were given phototherapy (cases), 19 did not have jaundice (controls). The two groups were compared for strength of DAT, neonatal risk factors such as asphyxia, sepsis, exclusive breast feeding, excess weight loss and maternal risk factors including Indirect Antiglobulin Test (IAT) status. A statistically significant increase in the bilirubin levels from day 1 to day 3 (<i>p</i> value of < 0.05) was observed. Multivariate regression analysis performed showed significant association between the risk factors and neonatal serum bilirubin levels.</p><p><strong>Conclusion: </strong>In the department of Neonatology, a positive DAT is an indicator to perform bilirubin levels in the newborn and subsequently monitor these levels. DAT also helps to diagnose if blood group mismatches are the reason for the hyperbilirubinemia. This is essential for the management of neonatal jaundice. However, in addition to positive DAT, the presence of other neonatal and maternal risk factors also influences the severity of neonatal hyperbilirubinemia.</p>","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"613-621"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676299","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":"Association Between Gravidity and Anemia in Tabari Cohort Population: A Case-Control Study.","authors":"Saber Palar, Mohammad Eslami, Akbar Hedayatizadeh-Omran, Mahmood Moosazadeh, Motahareh Kheradmand","doi":"10.1007/s12288-024-01903-x","DOIUrl":"https://doi.org/10.1007/s12288-024-01903-x","url":null,"abstract":"<p><p>Anemia is a global public health concern. It is more prevalent in women and previous studies have mostly been limited to pregnant women. Therefore, this study aimed to investigate the association between gravidity and anemia in a subset of women enrolled in the Tabari Cohort study. This case-control study included 1676 women aged 35-70 years old with at least one pregnancy. The case group consisted of 838 women who were anemic by definition, and were included using the census method. The control group (838 women) was randomly selected from the rest of the study population based on age. In this study, a subset of data from the enrolment phase of the Tabari cohort was analyzed. Statistical analysis was performed using multivariate logistic regression, chi-square test, and independent sample t-test in SPSS. The mean gravidity in the case and control group was 3.23 ± 1.74 and 3.53 ± 1.98, respectively (<i>P</i> = 0.001).In the case group, the frequencies of 1, 2, 3, 4, and ≥ 5 gravidity was 10.3%, 30.2%, 25.8%, 15.5%, and 18.3%, respectively; in the control group, the frequencies were 8.2%, 27.8%, 24.7%, 14.9%, and 24.3%, respectively (<i>P</i> = 0.036). After adjusting for all confounding variables, the OR (95%CI) of gravidity 2, 3, 4, and ≥ 5 for anemia were 0.89 (0.60-1.33), 0.81 (0.52-1.26), 0.75 (0.45-1.24), and 0.52 (0.30-0.88), respectively. The findings of the present study showed that although the mean gravidity in the control group was significantly higher than that in the case group, women with gravidity ≥ 5 had a lower risk of developing anemia than those with only one pregnancy.</p>","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"565-570"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676214","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":"Hb Koya Dora: An Under-recognized Variant of Alpha Thalassemia in India.","authors":"Ekta Jajodia, Ankit Jitani, Pritish Patra, Ayondyuti Bora, Jina Bhattacharyya, Spandan Chaudhary, Firoz Ahmad, Pooja Chaudhary, Jigarkumar V Suthar, Neeraj Arora","doi":"10.1007/s12288-024-01896-7","DOIUrl":"10.1007/s12288-024-01896-7","url":null,"abstract":"<p><p>α-thalassemia is a lesser diagnosed form of hemoglobinopathy, mainly due to limited diagnostic tools available to confirm this entity. Molecular tests are commonly required to confirm the diagnosis, accessibility to which is difficult at times. There is profound phenotypic heterogeneity in different types of α-thalassemia, making it challenging to suspect the same. Subtle and easily overlooked clues in the hemoglobin electrophoresis or high performance liquid chromatography may be a pointer towards the diagnosis. Awareness about these subtle clues is paramount for diagnosis, as targeted next generation sequencing test done very commonly for unexplained haemolytic anemia may miss α-thalassemia as some of these panels may lack <i>HBA1</i> and <i>HBA2</i> genes. This series discuss four cases of Hemoglobin Koya Dora, a type of non-deletional α-thalassemia. The varying genotype and its association with clinical phenotype are briefly discussed.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12288-024-01896-7.</p>","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"688-693"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676302","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":"Blood Grouping - Basic Yet Powerful Tool: Case Highlighting the Importance of Blood Group Awareness and Testing Policies.","authors":"Deepti Sachan, Jyotsnaa Grace V M, Deepthi Krishna G","doi":"10.1007/s12288-024-01884-x","DOIUrl":"10.1007/s12288-024-01884-x","url":null,"abstract":"","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"717-718"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676216","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":"\"Light Chain Amyloidosis with Extensive Deposition in Bone Marrow Aspirate Smears\".","authors":"Madhu Kumari, Amber Parwaiz, Megha Saigal","doi":"10.1007/s12288-024-01882-z","DOIUrl":"10.1007/s12288-024-01882-z","url":null,"abstract":"","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"741-742"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676277","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":"Real-World Efficacy and Safety of the Combination of Rituximab, Lenalidomide, and Ibrutinib in Patients with Relapsed and/or Refractory Non-Hodgkin Lymphoma.","authors":"Derya Koyun, Uğur Şahin, Ayla Gökmen, Muhit Özcan","doi":"10.1007/s12288-024-01897-6","DOIUrl":"https://doi.org/10.1007/s12288-024-01897-6","url":null,"abstract":"<p><p>Relapsed or refractory (R/R) non-Hodgkin lymphoma (NHL) is associated with poor outcomes, and the therapeutic options are limited. In some clinical studies, rituximab, lenalidomide, and ibrutinib (RLI) have shown promising efficacy. Consequently, we evaluated RLI in a real-life setting. This retrospective, single-center study analyzed the outcomes of RLI as an off-label salvage therapy in patients with R/R NHL from June 2020 to 2024. We analyzed twenty-four patients, including diffuse large B-cell lymphoma (DLBCL) (<i>n</i> = 18), primary central nervous system lymphoma (PCNSL) (<i>n</i> = 2), mantle cell lymphoma (MCL) (<i>n</i> = 2), and marginal zone lymphoma (MZL) (<i>n</i> = 2). The most common adverse events (AEs) were fatigue (42%), neutropenia (42%), and infection (33%). The median time to response (TTR) was two months (1.7-3.8). The overall response rate (ORR) was 46% (95% CI 24%-67%), with 33% complete response (CR) and 13% partial response (PR). The median duration of response (DoR) was 31 months (range, 0.6-46+). The median overall survival (OS) was eight months (95% CI 2.2-13.7 months), and the median progression-free survival (PFS) was 6.3 months (95% CI 0.0-25.1 months). Our results suggest that RLI is a viable therapeutic option with promising activity and a favorable toxicity profile in patients with R/R NHL.</p>","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"511-518"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676284","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":"Elevated Serum Vitamin B12 Levels and Functional Vitamin B12 Deficiency among Patients with Myeloproliferative Neoplasms.","authors":"Murugesan Harini, Kolar Vishwanath Vinod, Prashant S Adole, Biswajit Dubashi","doi":"10.1007/s12288-024-01877-w","DOIUrl":"10.1007/s12288-024-01877-w","url":null,"abstract":"<p><strong>Background: </strong>Despite elevated serum vitamin B12 levels, functional (i.e., metabolically manifest) vitamin B12 deficiency has been reported in a significant proportion of MPN patients. This study aimed to assess the prevalence of functional vitamin B12 deficiency and elevated serum vitamin B12 levels among Indian MPN patients.</p><p><strong>Methods: </strong>This cross-sectional study evaluated serum vitamin B12, homocysteine, methyl malonic acid (MMA) and holotranscobalamin levels among 176 MPN patients. Serum vitamin B12 levels between 150 and 950 pg/mL were considered normal. Functional vitamin B12 deficiency was diagnosed based on combination of elevated serum MMA (> 0.4 nmol/mL) and homocysteine (> 15 µmol/L) levels and low serum holotranscobalamin levels (< 25 pmol/L), irrespective of serum vitamin B12 levels and clinical manifestations of deficiency.</p><p><strong>Results: </strong>Among patients enrolled (<i>n</i> = 176), 108 (61%) had chronic phase CML, 37 (21%) PV, 23 (13%) PMF and 8 (4%) ET. Nearly one-third were newly diagnosed to have MPNs and treatment naïve. Elevated serum vitamin B12 levels (> 950pg/mL) were seen in about a quarter (<i>n</i> = 45) of MPN patients. Half (<i>n</i> = 89) were detected to have functional vitamin B12 deficiency. No association was found between functional vitamin B12 deficiency and serum vitamin B12 levels and functional deficiency prevalence did not differ significantly between different types of MPNs and between newly diagnosed (treatment-naïve) and already treated MPNs.</p><p><strong>Conclusion: </strong>About a quarter of MPN patients had elevated serum B12 levels and half had functional vitamin B12 deficiency. Functional deficiency was diagnosed independent of serum vitamin B12 levels. Hence, evaluation for functional deficiency should be carried out irrespective of serum vitamin B12 levels. Future studies should evaluate potential benefit of vitamin B12 replacement in MPN patients with functional vitamin B12 deficiency.</p>","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"530-537"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676222","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":"Renal Impairment in Myeloproliferative Neoplasms: An Under-reported Complication.","authors":"Rintu Sharma, Arihant Jain, Charanpreet Singh, Aditya Jandial, Deepesh Lad, Alka Khadwal, Gaurav Prakash, Ritambhra Nada, Raja Ramachandra, Neelam Varma, Pankaj Malhotra","doi":"10.1007/s12288-024-01888-7","DOIUrl":"10.1007/s12288-024-01888-7","url":null,"abstract":"<p><p>Renal involvement in myeloproliferative disorders (MPNs) is rare and presents unique challenges in terms of diagnosis and treatment. The exact pathogenesis of renal dysfunction in MPNs remains unclear. Most of these patients are elderly and have comorbid conditions that contribute to their renal dysfunction. Although symptomatic patients typically present with proteinuria, hypertension, anasarca, and hematuria, many patients remain asymptomatic with incidental detection of renal impairment. Early diagnosis using renal biopsy and prompt initiation of treatment with corticosteroids, cytoreductive drugs, and targeted agents are crucial for achieving a favorable outcome. We present a series of case vignettes describing our approach and management strategies in a spectrum of MPN patients (primary myelofibrosis, essential thrombocytosis, chronic myeloid leukemia, and pre-fibrotic myelofibrosis) with biopsy proven etiologies of renal dysfunction. Although extramedullary hematopoiesis was a common finding in all our cases, we discuss the various other mechanisms by which MPN can target the kidneys. Despite the widespread use of cytoreductive and targeted therapies, such situations require an individualized approach along with multidisciplinary effort.</p>","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"680-687"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676286","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":"Role of Transient Elastography in Pediatric Transfusion Dependent Thalassemia Patients from Lower Socioeconomic Strata and its Correlation with Serum Ferritin: A Cross-Sectional Study.","authors":"Shambhavi, Kumar Shwetanshu Narayan, Ananya Ghosh, Olie Mitra, Pawan Kumar Dubey, Mrinal Manjari, Ujjawal Sahay","doi":"10.1007/s12288-024-01906-8","DOIUrl":"10.1007/s12288-024-01906-8","url":null,"abstract":"<p><p>Thalassemia is a very common single gene disorder worldwide. They regularly require blood transfusions resulting in excessive accumulation of iron in various organs. The liver is the first organ to accumulate iron and this excessive iron leads to hepatic fibrosis. Data regarding prevalence of hepatic fibrosis in children is lacking. Transient elastography (TE) is a recent non-invasive test to estimate liver-stiffness. Its role in children with thalassemia has not been fully investigated. We aimed to see the prevalence of hepatic fibrosis in transfusion dependent thalassemia (TDT) patients belonging to lower socioeconomic-strata and correlate the degree of hepatic fibrosis with serum ferritin. This cross-sectional study was conducted in July 2023 in tertiary care hospital in TDT children from lower socio-economic strata, aged 3-13 years who were negative for Hepatitis C and B. Blood investigations and TE were conducted in all the included patients and statistical analysis was done. 45 patients fulfilled inclusion and exclusion criteria. Mean age was 6 years, Mean serum ferritin was 2010.2 ng/ml, mean Liver stiffness Measurement (LSM) score was 9.25 kPa. 51.1% of study subjects had varying degree of hepatic fibrosis. We found significant positive correlation between serum ferritin and LSM score. We conclude that prevalence of hepatic fibrosis is high in TDT children and TE can be used to monitor hepatic fibrosis in this vulnerable group of patients.</p>","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"558-564"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676288","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 Importance of Blood Inflammatory Parameters in the Assessment of Hemodynamically Significant Coronary Artery Stenosis.","authors":"Farhad Arefinia, Ali Ghaemian, Maysam Rezapour, Reza Rabiei, Versa Omrani-Nava","doi":"10.1007/s12288-024-01909-5","DOIUrl":"10.1007/s12288-024-01909-5","url":null,"abstract":"<p><p>Coronary artery disease (CAD) remains a major global cause of mortality, with inflammation playing a pivotal role in its pathogenesis. This study aimed to assess inflammatory ratios from blood count in CAD patients with moderate coronary lesions. This study was done at Mazandaran University of Medical Science (2013-2020) including patients with moderate coronary lesions based on fractional flow reserve (FFR) measurements. Demographics, laboratory features, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were assessed based on FFR categories. A total of 97 patients (mean age: 62.3 ± 9.6 years) were analyzed. FFR ≤ 0.80 correlated with higher NLR (<i>P</i> = 0.009) and PLR (<i>P</i> = 0.0948). SII showed similar trends without significance (<i>P</i> = 0.1081). Each one-unit increase in NLR and SII correlated with a 0.05 reduction in FFR (<i>P</i> = 0.003); for PLR, it was 0.06 (<i>P</i> = 0.011). This study highlights potential links between blood inflammatory ratios and FFR in CAD patients with moderate coronary lesions. While NLR showed significance with FFR ≤ 0.80, further research is needed to ascertain their prognostic value in guiding decisions for patients with intermediate stenosis.</p>","PeriodicalId":49188,"journal":{"name":"Indian Journal of Hematology and Blood Transfusion","volume":"41 3","pages":"704-708"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676291","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}