فصلنامه خون
سال ششم شماره 3 (پیاپی 24، پاییز 1388)

Background and Objectives Immune thrombocytopenic purpura is the most common cause of sudden onset of thrombocytopenia in a healthy child. The object of the present study was to determine the demographic and clinical features, underlying factors which predict chronicity of disease, and quality status of bone marrow megakaryocytes of children with ITP. Materials and Methods We conducted a 5-year retrospective study on children with a diagnosis of ITP in Mofid Children Hospital from 2003 to 2008. Data were analysed by using SPSS software. ResultsForty seven point one and 52.9% of 153 patients with ITP were female and male, respectively. The mean age was 4.42 ± 3.9 years (age range within 0.08-15 yrs). Among the patients, 70.8% had acute ITP and 29.2% chronic ITP. Distribution rates of petechiae and purpura over the patient's body were 54.9%, 32.7%, and 89.5% in head and neck, in trunk, and on extremities, respectively. There was a statistically significant correlation between age and epistaxis. In our study, 41.8% of patients had history of viral infection three weeks prior to presentation. The median platelet count was 19000/µl. A total of 147 cases underwent bone marrow aspiration in 61.2% of whom megakaryocyte count faced an increase, in 32% showed to be normal and in 6.8% on the contrary faced a decrease. ConclusionsIn our study, no correlation was found either between megakaryocyte counts and acute or chronic ITP or between treatment response and chronicity. Insidious onset was the strongest predictor of chronic disease.

Background and Objectives Many studies have provided conclusive evidence for the existence of terminal deoxynucleotidyl transferase (TdT) positive cases in some subgroups of AML. In approximately a half of studies TdT expression is correlated with poor prognosis. The incidence of TdT positive cases in patients varies in a wide range. This study was performed to determine the incidence of TdT expression in AML patients in our community and its positivity in morphologic subgroups at different sex and age groups. Materials and MethodsIn this study, 101 AML patients having referred to the Hematology and Oncology Center of Tabriz University of Medical Sciences were included. Data about FAB subgroups, sex, age and flowcytometry of patients were analyzed in SPSS software. ResultsTdT positive cells were detected in 24 patients (23.7%) two thirds of whom male. The median age of TdT positive patients was 30 years versus 40 in TdT–negative patients. Out of the 24 patients in the former, the age of 9 patients was under 20 years. TdT positivity was significantly associated with FAB M2 cases with 39% of whom being TdT-positive while this percentage in other FAB classes is calculated to be 15.3% (p= 0.004). ConclusionsThe TdT expression in AML is correlated with age. It is more common in patients under the age of 20. Although TdT expression is more common in M1/M2 AML cases, it also can occur in other FAB subtypes of AML.

Background and Objectives Fibrin sealant (FS) is a plasma derived product and has hemostatic, sealing and healing properties and is frequently used to reduce blood loss during and after surgery. Blood bank autologous fibrin sealants have no risk of transfusion transmitted diseases. The aim of this study was to obtain of thrombin and fibrinogen from FFP and study their in vitro properties for preparation of FS. Materials and MethodsFibrinogen was precipitated by use of protamin sulfate. Fibrinogen concentration was assayed with an enzyme-linked immunosorbent assay and clotting clauss method; the effect of temperature on fibrinogen precipitation was also evaluated. Thrombin was prepared by manual method and TPD and its activity was then determined using specific chromogenic substrate spectrophotometric assay. Thrombin stability at different temperature degrees was evaluated and clotting time was measured. Tensile strength and adhesion strength were evaluated with the tensiometry device. Clot lysis time was determined by a clot solubility test in 5M urea. ResultsFibrinogen concentration precipitated with protamin sulfate was measured as being 73 ± 8 mg/ml. The recovery of fibrinogen in cryoprecipitate was 93%. Thrombin mixed with fibrinogen had clot time of less than 5 seconds. Tensile strength and adhesion strength of fibrin sealant were 60 ± 8.9 g/cm2 and 55 ± 9 g, respectively. The average activity of the thrombin produced manually was 59.6 ± 6.2. Adding anti-fibrinolttic agent to fibrinogen concentrate has no effect on clotting time and tensile strength but it causes the stability improvement of fibrin clot. ConclusionsFibrinogen and thrombin prepared in this experiment have appropriate properties for production of fibrin sealants.

Background and ObjectivesIn order to identify acutely infected blood donors before seroconversion and to reduce the potential risk of transfusion-associated hepatitis C, the detection of HCV RNA by NAT has therefore been introduced recently in several developed countries. In this study, the molecular screening of HCV RNA among anti-HCV negative blood donors was carried out in Iranian Blood Transfusion Organization Research Center, Tehran. Materials and MethodsEight thousand samples negative for anti-HCV (EIA, third generation) were screened for HCV RNA in 25 mini-pools. A total of 320 mini-pools were tested using RT-PCR method for qualitative detection of HCV RNA, with a lower limit of detection of 200 IU/ml. ResultsAll samples tested by RT-PCR method were negative for HCV RNA. On initial testing, two false positive results were defined as positive but on repeat single testing they came out to be negative. ConclusionsHCV RNA detection by PCR can be carried out routinely without any significant delay in release of blood components. The residual risk of transmission can be reduced by identification of early infection which can lead to an improvement in safety of blood components. It was also shown that combined screening using anti-HCV and 25-mini-pool HCV RNA testing can be both useful and cost-effective.

Background and ObjectivesNPM1/Nucleophismin/B23 is a phosphoprotein with high expression in the proliferating cells. NPM1+AMLs are also frequently associated with FLT3 ITD mutations. The purposes of this study were to assess the frequency of NPM1 and FLT3 ITD mutations among Iranian AML patients and their correlation with FAB subtypes of AML. Materials and MethodsBone marrow and peripheral blood samples of 131 AML patients were randomly collected, and their DNA was then extracted. Afterwards, PCR was applied to the fragment of NPM1 gene with specific primers. PCR products were electrophoresed using CSGE method. In the end, the positive samples were sequenced to confirm the presence of NPM1 mutations. Furthermore, FLT3 ITD positive cases were screened using PCR and 2.5% agarose gel electrophoresis. ResultsOut of 131 patients, 23 (17.55%) (CI 95% = 0.107-0.244) were known to have NPM1 gene mutations. The highest frequency was among the subtypes of M4 (30.4%), M3 (21.7%), and M5 (13%). Also, 21 samples (16.03%) (CI 95% = 0.092-0.229) had FLT3 ITD mutations with 8 cases being NPM1 positive and other 13 NPM1 negative. ConclusionsNPM1 mutations are more frequent in monocytic subtypes (M4, M5). High frequency rates of NPM1 in M3 subtypes and allele D mutations in all subtypes together with the high degree of association between occurrence of NPM1 and FLT3 ITD mutations could be considered as interesting findings of the study (p=0.012).

Background and ObjectivesThe lack of eligible volunteers in many countries has turned into a crisis in blood services. So it is necessary to prepare purposive programs to meet ever increasing demands for blood. The goal of this research is to determine the knowledge level of eligible donors and study their attitude about blood donation. Materials and Methods This study was conducted at two stages. At the first stage, a pilot study on 60 eligible blood donors was done; they were instructed to answer open-ended questions in the questionnaire. At the second stage, data collection was done from July to October 2006 on 1130 non-blood donors living in Mashhad who were eligible for blood donation. These potential donors were selected by the two stage probability sampling method. Results Less than 30% of the cases had adequate knowledge about blood donation. There is a significant relationship between location, age, education, occupation and social status with knowledge of blood donation (p<0.05). Statistical results show that the attitude towards blood donation is mostly positive. The highest positive attitude towards encouraging factors was estimated to be 83% and the highest negative attitude towards the negative factors 58%. ConclusionsIn order to increase voluntary blood donation, we have to change the negative attitude towards blood donation by increasing relevant knowledge.

Background and ObjectivesKnowing the frequency of D,C,E,c,e antigens is necessary for population studies and plays a significant role in paternity tests. The purpose of this research is to determine the frequency of Rh antigens and their phenotypes in Khorramabad blood donors and to set up the data bank of individuals lacking the very common antigens. Materials and MethodsThe study was carried out as census on 1236 blood donors referring to Khorramabad Blood Center. Appropriate cell suspensions were incubated with several Rh antiserums; then, based on the type of reactions observed and most probable genotypes identified by reference to tables of Rh antigens frequency in black and white populations, phenotypes for main antigens were determined. ResultsOut of all observed reactions, the most common ones were associated with the e antigen (94.34%, CI 95%= 91.57-97.10) and the least with the E antigen (43.5%). As to D antigens, 92.88% (CI 95% = 90.14-95.65) of individuals were positive and 7.4% were negative. The results were 73.5% and 71.2% for C and c antigens, respectively. ConclusionsA 92.88% frequency for D antigen in Khorramabad city blood donors indicates a high regional difference in frequency. As a result, Rh negative blood units in the region deserve much more attention. In the meantime, the relatively significant frequency of e negative donors in the region more than ever emphasizes the necessity of setting up an e negative blood bank.