فصلنامه خون
سال سیزدهم شماره 3 (پیاپی 53، پاییز 1395)

An important consequence of chronic blood transfusion in thalassemia is iron overload with treatment of iron chealation drugs. One of these drugs is deferiprone (L1) which is usually used as the combination therapy with desferoxamin especially in patients with iron overload. Nausea and vomiting is the common side effects of L1 which sometimes gets so bad that the patient can not tolerate the drug. We tried Enteric coated; EC with the aim of decreasing the gastric side effects.
We started enteric coated for 100 patients and followed them for gastric side effects for six months. All of them could not tolerate the previous form of L1 because of severe nausea and vomiting.
Two of our patients moved to other cities and could not be followed by this therapy; 98 patients were studied: 91 thalassemia major and 7 intermedia, 39 male, 59 female with the mean age of 25.16 6.03. Out of the total number, 67 (68.4%) patients were on the combination therapy because of high ferritin level and 31 (31.6%) had cardiac iron overload and high ferritin level. Four patients could not continue the treatment, 3 because of the recurrence of nausea and vomiting and 1 because of artheralgia; however, 94 (96%) could tolerate the EC form and successfully continued the treatment.
The enteric form of L1 had good results on GI side effects reduction so that 96% of patients could tolerate the medication and continue the treatment without any nausea and vomiting.

The source of blood is human. The use of blood and blood requests are very important in saving life. The aim of this research was to evaluate the blood request and the use of blood in one of the clinical departments.
This was a cross-sectional descriptive study. During the 18 months, we observed 1097 patients with 1108 different surgeries and blood ordering (from March 2013 to Sep 2014). The data were analyzed with SPSS version 22.
Majority of the patients (50.95%) were within the age range of 26 to 40 years and 34.99% within 41 to 60. From 1108 blood orders, 9747 units were cross matched out of which 1389 units (14.25%) were transfused. The most common surgeries which needed blood were: hysterectomy (abdominal and vaginal) (34.27%), cesarean section (22.7%), and myomectomy (21.01%). In cesarean section, from 1780 ordering units, only 250 units of packed cell were transfused. In the emergency situation, O negative can be administered to any recipients; out of the 430 O negative ordered packed cell units cross matched for 42 recipients, only 52 units (12%) were transfused and 88% were left unused.
Conclusions :We observed the majority of blood units requested were left unused.

Neutrophil alloantigens are involved in several blood transfusion reactions including transfusion related acute lung injury (TRALI), refractoriness to granulocyte transfusions and febrile transfusion reactions (FNHTRs). Due to lack of reports on neutrophil antigens, we aimed to detect the frequency rates of HNA-3a and HNA-3 b antigens in some blood donors living in Tehran.
Blood samples were collected in EDTA (anticoagulant) containing tubes from 110 blood donors having referred to Tehran Blood Center. DNA was extracted by silica filtered columns. PCR-SSP was used for evaluation of HNA-3a, HNA-3b. The gene frequency rates of HNA 3a and HNA-3b antigenes were calculated by Hardy Weinberg equilibrium.
The gene frequencies of HNA-3a, HNA-3b were 0.74 and 0.26, respectively showing consistency with the Hardy-Weinberg equilibrium. HNA-3a phenotypic frequency was found in 103 (93.6%) blood donors while 7 (6.4%) showed lacking it. HNA-3b was found in 50 (45.5%) blood donors while 60 (54.5%) lacking. There was not found any differences in gene and antigene frequency rates between the two genders.
The frequencies of HNA-3a and -3b were similar to those found in the previous study conducted on German and Turkish populations.

The improvement of the quality of health care services, the enhancement of the safety in services, the establishment of patient satisfaction, and hemovigilance are some of the main factors which illustrate the necessity of using new technologies in health care services. RFID is a type of wireless technology which can help to increase the quality of services provided in hospitals. The purpose of this study is to identify waste in the blood use in hospitals, apply tracking tools to improve the use of blood products, and reduce the loss of blood.
The research is based on the real and tangible need in the hospital environments and it is an applicable research. To find the impact of RFID system on the improvement of service quality and the reduction of the blood wastage, it was put to a simulation test that was favored over the real test for the reasons of cost effectiveness. In this study, after reviewing the current situation and identifying the causes of blood wastage, “Discrete Event” simulation and Enterprise Dynamic (ED) software were used to simulate the proposed model and improvement scenario (using RFID).
Simulation results show that the average total loss of blood products, after implementation of RFID (over six months), has experienced a decrease rate of about 75%.
RFID system can affect the inventory management, and make real-time tracking and recording of information possible thereby ensuring more accuracy in blood transfusion attempts.

Dangerous infections such as hepatitis B, C and HIV can be transmitted through blood transfusion. The purpose of this study was to evaluate the frequency of hepatitis B, C and HIV infections among Sabzevar blood donors based on demographic characteristics, during 2009-2013.
In this cross-sectional study, required information including demographic characteristics and serologic test results (HBsAg, Anti-HCV, Anti-HIV) of all blood donors during 2009 to 2013 were extracted from records. Data were analyzed using descriptive statistics (frequency and percentage) using SPSS software version 18.
The total number of blood donors was 57335 people. Frequency rates of Hepatitis B, Hepatitis C and HIV were 3, 0.2, and 0 per 1000, respectively. The highest and the lowest infection rates were in donors over 50 years and 21-30 years, respectively (7.1 and 2.1 per 1000). The infection frequency was higher in women than men (4.1 and 3.1 per 1000, respectively), and in married than singles (3.3 and 2.5 per 1000). Also, the infections frequency was higher in the first-time donors than regular and multi-time donors with Hepatitis B, Hepatitis C and HIV rates of 11.4, 0.1, and 0.08 per 1000, respectively.
Conclusions : The results show low levels of hepatitis B and C and the absence of HIV infections among Sabzevar blood donors. This indicates the effectiveness of screening methods, and thus the safety of blood products in Sabzevar.

Leukemia is a cancer type in the world. One of the most accurate methods for detection and prediction of Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia is to use DNA and genetic information of people. Microarray technology is a tool to study the expression of thousands of genes in shortest possible time. Analyzing the microarray datasets may not be possible without the statistical analysis and machine learning techniques. In this paper, microarray data sets and machine learning techniques are used for the diagnosis of leukemia.
The data used in this descriptive study are the expression of 7129 genes of 72 patients with leukemia which have been achieved by the microarray technology. Then, the diagnosis of AML and ALL was performed using the microarray data based on anisotropic radial basis function with the gain ratio and information gain.
The proposed method using information gain with the selection of 230 important genes and using gain ratio with the selection of 86 important genes was able to detect AML and ALL with accuracy of 97. 06%, whereas non-parametric kernel classification method based on the radial basis function has the accuracy of 35. 29٪ with 7129 genes.
The results of this study showed that the gene expression data and proposed method with gain ratio method are able to detect leukemia with high accuracy. Therefore, it seems that proposed method can help to accurately diagnose leukemia for a better decision making about the diagnosis of diseases and treatment of patients.

Deregulation of microRNA (miRNA) expression can lead to cancer initiation and progression. The aim of this study was to investigate miR-125a expression level in patients with myeloproliferative neoplasm and its correlation with JAK2 allele burden and laboratory findings.
This is an experimental study. In total, 20 patients with Polycythemia Vera (PV) and 20 patients with essential thrombocythemia(ET) were examined. Ten healthy subjects were checked as controls. We performed JAK2 V617F allele burdens measurement by quantitative real-time polymerase chain reaction. Expression analysis of miR‑125a-3p and miR-125a-5p was performed by Real-time RT-PCR. Results were analyzed by SPSS 16 software and Mann–Whitney test and Spearman’s correlation was applied for analysis.
miR-125a-5p was up regulated in both PV (p = 0.003) and ET patients (p = 0.002). In PV group, a significant correlation was observed between miR-125a-5p and platelet counts (p = 0.01, r = 0.531). The median allele burden of the JAK2 V617F was 66% (62.37 ± 18.29) for patients with PV and 40% (43.4 ± 13.95) for patients with ET (p = 0.007).
In conclusion, our data indicate that there is the aberrant expression of miRNAs such as miR-125a in MPNs patients except JAK2 mutation.

MicroRNAs play a crucial role in controlling the innate and adaptive immune responses, inflammation, cell growth, and apoptosis by regulating gene expression at post-transcriptional level. In addition, many microRNAs act as oncogenes, tumor suppressors, and the mediators of cancer stem cells. MiR-146a is one of the important microRNAs in inflammatory diseases and tumors which has a dual effect on cancers and acts as a tumor promoter or a tumor suppressor. The present study aimed to evaluate the expression of miR-146a in multiple myeloma cell lines (L363, LP1, RPMI 8226 and KMM1) in comparison with normal leukocytes.
In this experimental study, four myeloma cell lines and peripheral blood leukocytes isolated from healthy individuals were cultured under specific conditions. After RNA extraction, miR-146a expression was measured by quantitative Real Time PCR.
The research results showed that the expression of miR-146a in multiple myeloma cell lines was significantly decreased compared with normal leukocytes. Data analysis also revealed that the expression of miR-146a was decreased in average of 0.32 ± 0.2 folds in L363 cell line and for LP1, RPMI 8226, and KMM1 cell lines in average of 0.03 ± 0.07, 0.0035 ± 0.02, 0.0022±0.001 folds, respectively (p Conclusions :The researcher's results suggest that miR-146a can act as a tumor suppressor in leukocytes, and the decreased expression of this microRNA in myeloma cells is likely to be effective at the onset and progression of multiple myeloma.

Human factor IX (hFIX) during maturation in the liver requires carboxylation of glutamic amino acids in the Gla domain, which is involved in its secretion and activity. Due to the deficiency of mammalian expression systems in the secretion and fully γ_carboxylation of recombinant coagulation factors and higher activity of γ_carboxylase enzyme in Drosophila S2system, the present study was performed to evaluate ability of this system in γ_carboxylation, secretion and activity of recombinant hFIX.
In this study, following transfection of S2 cells with pMT-hFIX vector, the ELISA and aPTT tests were used to evaluate the expression and activity of recombinant hFIX. In addition, γ_carboxylation of factor IX was approved by barium citrate precipitation. The samples were analyzed on three consecutive days and being repeated three times.
The coagulation results showed the secretion of active recombinant hFIX by stable S2 cells. Quantitative assessment of recombinant hFIX in medium and cell lysis with ELISA showed 94% secretion efficiency. The results of ELISA on precipitated FIX with barium citrate also indicated that about 45% of secreted recombinant hFIX from S2 cells are fully carboxylated.
Activity and barium citrate precipitation of recombinant hFIX confirmed the ability of S2 cells, unlike other insect cells, in the γ_carboxylation of factor IX. So, our results provide convincing evidence that Drosophila γ_carboxylase perform necessary γ_carboxylation required for secretion and coagulation activity of recombinant hFIX.

Bacterial infection following platelet transfusion is a major problem in transfusion medicine. The present study was carried out in order to evaluate the bacterial contamination of platelet concentrates collected at Tehran Regional Educational Blood Center.
In this cross-sectional study, 630 random samples of platelet transfusion in both groups (360 subjects using triple bags without sampling pouch and 270 samples using triple bags with sampling pouch) were selected. Bacterial growth of samples of platelet concentrates was studied in blood agar, EMB and thioglycollate broth after 48 hours at 37°C. The use of differentiation tests was made when any bacterial growth was observed. SPSS 19 has been used for data analysis.
Out of 630 samples of platelet concentrates studied, 5 (1.39%) were found positive for bacterial contamination all taken from the platelet samples (360 samples) prepared by triple bags without sampling pouch. The bacteria identified were as follows: Staph. Epidermidis (n = 3), Staph. saprophyticus (n= 2). In the platelet samples (270 samples) made from triple bags with sampling pouch, there was no contamination.
Conclusions :Due to advances in the collection, preparation and storage of platelet concentrates, transmitted bacterial infection caused by contaminated platelets dropped significantly. This is due to the efforts of effective quality control processes to improve the quality of blood transfusion.