فصلنامه خون
سال هجدهم شماره 2 (پیاپی 72، تابستان 1400)

Fresh frozen plasma is the plasma that retains its unstable protein activity during the freezing process. The purpose of this study was to investigate the quality of FFP products during 1397- 1398.

In this cross-sectional descriptive study, quality control results of FFP parameters of blood transfusion departments were collected in EXCEL 2019. The ratio of compliance was investigated using Med Calc Statistical Software and chi squared statistical method. Values of mean ± 1SD, parameters volume, FVIII, WBC, RBC and platelet counts and protein levels were compared by T-test method.

In the year 1397, 18744 and in the year 1398, 18282 FFP units were evaluated in terms of quality. The percentage of compliance of FFP quality parameters was increased in 1398 compared to 1397. The differences in the percentage of compliance in FVIII, RBC count and protein parameters were significant (p ≤ 0.05). Mean FVIII increased significantly and the number of  RBC, WBC, and platelets of FFP products in 1398 was significantly decreased compared to 1397 (p ≤ 0.05).

Conclusions  :

This study showed that more than 99% of the FFP units evaluated during the years 1397-1398 were in accordance with the standards of the Iranian Blood Transfusion Organization. Also, increase in the percentage of compliance with qualitative parameters in 1398, the increase in the average FVIII activity, and the significant decrease in the number of RBC, WBC and platelets of FFP products in 1398 compared to 1397 were indicative of improvement in the production process.

Various antibodies such as antibodies against RBC antigens, anti-HLA, and anti-platelet antibodies are developed after repeated blood transfusions and may lead to transfusion reactions such as platelet refractoriness in recipients. In this study, anti-HLA antibodies were evaluated in hemato-oncological patients, with and without simultaneous platelet refractoriness.

In this descriptive study, performed from 2017 to 2019, presence of anti-HLA antibodies in patients with hemato-oncological disorders, referred to the HSCT Research Center, Shariati Hospital, Tehran, was assessed using Panel Reactive Antibody (PRA) test based on complement lymphocytotoxicity. Data analysis was performed by SPSS (version 16) and chi-square tests.

Of 79 studied patients with hemato-oncological disorders including 34 females (43%) and 45 males (57%) with the age range of 2 to 83 years,  49 were platelet refractory and 30 were not. Anti-HLA antibodies were present in 39 (49.4%) patients and  40 (50.6%) were negative for them. The frequency of panel reactive antibody positive cases was significantly different between patients with platelet refractoriness (62.8%) and those without it (30%) (P = 0.007).

Conclusions :

The role of anti-HLA antibodies in platelet refractoriness is well established. Our study also showed a significant difference in this regard among two groups of hemato-oncological patients with and without platelet refractoriness. The presence of these antibodies does not always mean platelet refractoriness, and antibodies without the ability to activate complement can also cause this complication.

Blood transfusion like other medical interventions has some complications known as blood transfusion reactions. The record of these reactions is helpful in their management and patients treatments. This study has aimed to evaluate the rate of the reactions due to the transfusion of blood components among blood recipients who have had complications in hospitals of Hamadan.

In this cross sectional and retrospective study, the data of all 116 completed reports of possible reactions after transfusion of blood and blood components during 2018 and 2019 were inserted in to SPSS software version 16. The Data were analyzed using T-test, Chi-square and Fisher’s exact test. The significance level was determined as p < 0.05.

Based on the results, in a specialized blood hospital and four general hospitals, allergic reactions make the most common complication with 63 cases (53.4%) followed by febrile non hemolytic reactions with 28 cases (24.1%). A meaningful correlation was observed between RBC containing blood components and febrile non hemolytic reactions (p = 0.02). 68 patients  (58.6% cases) had a history of transfusion of blood products and 78 patients (67.2%) had no history of blood disease.

Conclusions  :

Allergic and febrile non hemolytic reactions had the highest prevalence in blood recipients. The administration of products containing RBC was related to febrile non hemolytic reactions of recipients.

Mixed Lymphocytes Culture (MLC), is a method studies the cell-cell interaction between subpopulations of lymphocytes and the production of compounds caused by this interaction. MLC as a source of cytokines can increase B lymphocytes proliferation. Repeated blood transfusions cause B lymphocytes alloimmunization. Cyclosporin A has inhibitory effect on immune system. In alloimmunization, stimulated B lymphocytes can produce antibodies against exposed foreign red blood cell antigens. Immortalization of B lymphocytes can lead to continuous production of monoclonal antibodies. Considering MLC as an important source of cytokines and the presence of B lymphocytes as a group of cells in  peripheral blood cells, the aim of this study was to produce MLC and evaluate its effect on proliferation of alloimmune peripheral blood cells in the presence or absence of cyclosporine A using microscopic evaluation and dye exclusion staining method.

In an experimental study, RhD antigen positive and negative lymphocytes were exposed together for MLC production. Peripheral blood lymphocytes resulted from two alloimmunized patients was treated with MLC and cyclosporine, and their proliferation was analyzed compared to the control group using microscopy and trypan blue staining method. The results were analyzed by t-test using prism software (p< 0.05).

MLC and cyclosporine increased proliferation of lymphocytes with mean value being 440000 (SD: 197989.8) vs 160000 (SD: 84852.8) of control group.

Conclusions  :

MLC and cyclosporine increase lymphocyte cells proliferation. By confirmation of additional experiments, MLC and cyclosporine may be used as effective agents in lymphocyte proliferation and antibody production of alloimmune B lymphocytes.

The association of JAK2 V617F mutation with myeloproliferative neoplasms was first reported in 2005. The present study was conducted to evaluate the frequency of JAK2 gene mutation in patients with myeloproliferative neoplasms in Kerman, Iran, from the years 2013 to 2018.

This descriptive cross-sectional study was performed among 276 patients with primary diagnosis of myeloproliferative neoplasms with subgroups PV, ET, PMF, and ABL-BCR negative referring to bone marrow laboratory of Bahonar Hospital during six years. Demographic, histopathologic, clinical, and JAK2 mutation data were collected. Data were analyzed by K2 test , Mann-Whitney U test and Kolmogorov–Smirnov test.

Out of the total number of participants, 176 (64.9%) were male and 100 (35.1%) female with 101 (36.6%) patients having primary thrombocythemia, 81 (29.3%) primary myelofibrosis, 72 (26.1%) polycythemia vera, and 22 (8%) without diagnosis. Of all patients, JAK2 mutation was positive in 184 patients (66.6%). But the results showed that the frequency of positive mutations was 54.4% in primary thrombocytic patients, 59.2% in primary myelofibrosis patients, and 88.7% in polycythemia patients. This difference was statistically significant. ( p = 0.016)

Conclusions  :

Considering the comparability of JAK2 V617F mutation rate in Iranian patients with myeloproliferative neoplasms and previous reports, in order to standardize the diagnosis and control of treatment and prognosis, it seems neccessary to evaluate this mutation along with other histopathologic evaluations.

Platelet Gel (PG) is rich in growth factors including Platelet-Derived Growth Factor (PDGF), Transforming Growth Factor (TGF-β), Vascular Endothelial Growth Factor (VEGF), Epidermal Growth Factor (EGF), and Fibroblast Growth Factor (FGF) that have healing properties. In this study, the platelet growth factors were evaluated in the platelet gel prepared from umbilical cord blood (CB) and peripheral blood.

In this case-control study, blood samples from 30 umbilical cord blood volunteers and 30 peripheral blood donors were evaluated. PG was prepared from the collected samples. The concentrations of platelet growth factors in platelet gel supernatant were measured at different storage times (0, 0.5, 1, 6, and 24 hours) using the enzyme-linked immunosorbent assay technique.

ELISA assay revealed that the concentration of PDGF and VEGF in CB-PG supernatant was dramatically higher following. 6 hours of incubation of PG (p< 0.01). The concentration levels of PDGF in CB-PG at 0 and 6 hours of incubation were 38.9 ± 7.1 and 73.2 ± 10.9 ng/mL, respectively. Also TGF and EGF levels were significantly increased following 24 hours of incubation (p< 0.01). At all times tested, the level of measured growth factors in CB-PG was higher than the peripheral blood PG.

Conclusions  :

A variety of growth factors is released from the platelets at significant levels in CB-PG which can mediate healing process.

The aim of this meta-analytical review was to compare the effect of different exercise training on plasma fibrinogen levels as well as to evaluate the acute and chronic response of fibrinogen to exercise.

In order to study the effects of exercise training on fibrinogen, a search was conducted in the databases of PubMed, Science Direct, Scopus, and Google Scholar. The search used identified keywords and reviewed articles published between 2010 and 2020. After the initial screening, full-text review and critical evaluation of the studies, the articles that met the inclusion criteria were analyzed. Finally, 22 studies including 33 trials with meta-analysis inclusion criteria were analyzed.

The results of meta-analysis show that the acute response of fibrinogen to exercises is incremental, but the increase is not significant. On the other hand, the chronic response of fibrinogen to exercises is significantly reductive, which is related to aerobic exercise and high-intensity interval training and the response to anaerobic exercise is negligible.

In general, it can be said that exercise can be effective in modifying vascular fibrinogen levels. In various studies, in the acute response to exercise, there have been no change or increase in plasma fibrinogen levels but in the chronic response to exercise, a decrease in plasma fibrinogen levels has been reported. However, there is still a need for high quality studies with a sufficient sample size in this field.

Ataxia telangiectasia is a disease with chromosomal instability that causes susceptibility to malignancy.

Case:

The patient was a 7-year-old boy living in Shiraz who had ataxia telangiectasia and was hospitalized due to fever and lymphadenopathy. Bone marrow aspiration showed a 60% blast population that was consistent with acute T cell lymphoblastic leukemia, immunophenotypically. In cytogenetic examination of bone marrow aspiration, complex chromosomal abnormalities as 42,XY,-5,del(6)(q22),der(8)t(8;17)(q24;q12~q22),t(9;16) (q12;q24),dic(12;14)(p11;q24),+13,-14,-22 were observed. Despite chemotherapy, the patient expired after two relapses of leukemia.

T cell acute lymphoblastic leukemia due to ataxia telangiectasia  can be associated with complex karyotype abnormalities leading to leukemia relapse and adverse prognosis.