Blood Center Research Articles

Extended blood group phenotyping of donors from the lower and middle Himalayan region of Uttarakhand India: A pilot study.

The state of Uttarakhand, bordering countries such as Tibet and Nepal, is a multi-ethnic region. Further, erythrocyte alloimmunization may arise from the incompatibility of major and/or minor blood groups between ethnically diverse donors and recipients. We aimed to screen Uttarakhand blood donors (UBDs) for extended phenotyping of their erythrocytes serologically. This prospective cross-sectional analysis involved all UBD samples collected at the blood centre of our tertiary-care hospital. Samples were obtained over 9months (Mar'22 to Nov'22). Donors who were O-typed, DAT-negative and non-reactive for TTI markers were processed further for serological testing using the column agglutination technique utilizing 21 different monoclonal antisera (Ortho diagnostics Pvt ltd, Mumbai India). The research was financially aided by UCOST, Uttarakhand, Government of India. Of the 5,407 blood samples collected, the total number of O-typed samples collected was 1622. Of these 1622, 329 (20.2%) O-typed samples were selected based on our inclusion criteria and hence further phenotyped. Amongst these 329 UBDs, the average age was 32.7±9.32 (18-52) years and the male-to-female ratio was (M: F=12:1). The prevalence of high- and low-frequency blood antigens in our study was Rh (D 96.6%, C 84.8%, c 63.5%, E 27.9% and e 92%), Lewis (Lea 6.3%, Leb 31.9%), Kidd (Jka 87.8%, Jkb 63.2%), Kell (K 1.8%, k 96.3%) and Duffy (Fya 63.5%, Fyb 10.6%). And in the MNS system we received 21.2% as M, 10.9% N, 37% S and 51.3% as s respectively. We also identified some very rare minor antigens such as Dia 1.8%, Ina 1.8%, Cw 0.6% and, 1.2% Mur positive donors, which are not common in our population, as per the published literature. Moreover, we also identified one Bombay blood phenotype (Oh) in one of our UBD recruits. To sum up, practically with the outcome of this research, we were also able to identify rare phenotypes among the local people and a rare blood donor registry was created. This repository shall also come in use for our multi-transfused patients having different oncological and haematological ailments.

Development of a recombinant hepatitis B immunoglobulin derived from B cells collected from healthy individuals administered with hepatitis B virus vaccines: A feasibility study.

In Japan, plasma with a high concentration of Hepatitis B Virus (HBV) antibodies for hepatitis B immunoglobulin (HBIG) is almost entirely imported. We aimed to produce recombinant HBIG by isolating immunoglobulin cDNAs against the HBV surface antigen (HBsAg). B cells expressing HBsAg antibodies were obtained from blood center personnel who had been administered HB vaccine booster and then isolated by either an Epstein-Barr virus hybridoma or an antigen-specific memory B cell sorting method. Each cDNA of the heavy and light chains of the target antibody was cloned into an IgG1 expression vector and transfected into Expi293F cells to produce a recombinant monoclonal antibody (mAb), which was screened by ELISA and in vitro HBV neutralizing assays. The cross-reactivity of the mAbs to normal human molecules was evaluated by ELISA and immunohistochemistry. Antibody cDNAs were cloned from 11 hybridoma cell lines and 204 HBsAg-bound memory B cells. Three of the resulting recombinant mAbs showed stronger neutralizing activity in vitro than the currently used HBIG. All three bind to the conformational epitope(s) of HBsAg but not to human DNA or cells. We successfully isolated HBV-neutralizing monoclonal antibodies from B cells collected from healthy plasma donors boosted against the HBV. To obtain an alternative source for HBIG, HBV-neutralizing monoclonal antibodies from B cells collected from healthy plasma donors boosted against the HBV may be useful.

Phenotypic and Allelic Frequency of ABO and Rh (D) Blood Group among Whole Blood Donors in a Teaching Hospital of Chhattisgarh

Background: ABO and Rh (D) blood groups are the most important in blood transfusion and are determined genetically. Although these blood groups are common to all humans, there is variation in their allelic frequency based on region and population. This study was performed to determine the allelic frequency of ABO & Rh (D) in the donor population in the Blood Center of Chhattisgarh located in Central India.
 Place and Duration of Study: It is a cross-sectional study performed in the Department of Transfusion Medicine & Blood Bank of a teaching hospital from July 2021-February 2022.
 Methodology: Only the accepted whole blood donors were included. ABO & Rh (D) blood grouping was performed by conventional tube technique and their allelic frequency was determined. We studied 4078 whole blood donors out of which 4055 were males and 23 were females.
 Results: Phenotypic frequency of ABO blood group system was O>B>A>AB. Rh (D) positive was more prevalent than Rh (D) negative. Allele frequency of ABO system was 0.1545 for IA, 0.2351 for IB, and 0.6105 for IO. In Rh system, allele frequency of ID was 0.8441 and Id was 0.1559.
 Conclusion: Phenotypic & allelic frequency of ABO & Rh (D) shows heterogeneous distribution in different parts of the world. Our study showed blood group O & allele IO as the most common. This data is of utmost importance in the planning of transfusion services, especially during a healthcare crisis in low-resource area like ours.

An exact criterion space search algorithm for a bi-objective blood collection problem

Blood shortages are one of the main challenges in blood supply chains. To supply required blood, blood center managers face conflicting collection objectives involving costs and patients’ lives. Moreover, some challenging decisions must be made, such as routing, blood collection, location of blood stations, transshipment policy and holding inventory. In this study, a bi-objective mixed integer mathematical model is developed to address all the above-mentioned issues in the network. The model focuses on precisely determining the location of collection stations (permanent and temporary), transshipment and inventory of the blood center, routes and the quantity of collected blood to optimize the two objectives of decreasing total blood shortages and costs. Next, a subtour cut generation (SCG) method is introduced to enhance the solution approach of the problem. It leads to solving large instances more efficiently. The problem is critical and complex since missing even a non-dominated solution may lead to both negative financial impact and noncompensable outcomes. To extract all non-dominated solutions, an exact criterion space search method, called the triangle splitting method (TSM), is adopted. Several experiments are investigated for some instances from the literature. In addition, a real case study is considered. Results indicate that designing the network using the proposed mathematical model can significantly reduce total blood costs and shortages. Consequently, by utilizing the proposed methodology, blood center decision makers will have the opportunity to choose the most preferred point among extracted non-dominated solutions. Furthermore, the performance of the adopted TSM was compared with an improved non-dominated sorting genetic algorithm (NSGA-II) and lexmin epsilon constraint (LEPS). The results confirm that the adopted TSM algorithm performs much better than the improved NSGA-II and LEPS, considering bi-objective performance measures.

Are Italian nurses ready for patient blood management program? A national social media survey.

Blood transfusion is one of the five most overused procedures in healthcare. Patient Blood Management (PBM) is a multimodal and multidisciplinary strategy that aims to properly manage the patient blood. In 2015 the Italian National Blood Centre explicitly mentioned the need for the identification of dedicated nursing staff to implement this approach. The purpose of this study is to investigate if Italian nurses are prepared and willing to implement the PBM. We conducted a social media survey that registered 235 respondents from the whole Italian territory over a one-month period (15th of May-15th of June 2020). The 23 open and closed-ended questions were intended to investigate the views, the inclinations, and intentions of healthcare professionals towards PBM. PBM can still be considered as a niche topic. Therefore, most respondents declared themselves willing to know more about it, to acquire new skills and grow professionally, to determine benefits for the hospital, to improve the quality of nursing care and act evidence based, and to enhance the nursing role in the multidisciplinary team. Conclusions: PBM programs are conducted and implemented effectively worldwide, and Italian nurses recognize its importance and are willing to implement it and be a part of it for what then bedside care, the educational, and the managerial role are concerned. (www.actabiomedica.it) Key words: Patient blood management, blood transfusion, bloodless nurse, bloodless coordinator, nursing education, nursing management.

Continued stabilization of blood collections and transfusions in the United States: Findings from the 2021 National Blood Collection and Utilization Survey.

National Blood Collection and Utilization Surveys (NBCUS) have reported decreases in U.S. blood collections and transfusions since 2008. The declines began to stabilize in 2015-2017, with a subsequent increase in transfusions in 2019. Data from the 2021 NBCUS were analyzed to understand the current dynamics of blood collection and use in the United States. In March 2022, all community-based (53) and hospital-based (83) blood collection centers, a randomly selected 40% of transfusing hospitals performing 100-999 annual inpatient surgeries, and all transfusing hospitals performing ≥1000 annual inpatient surgeries were sent a 2021 NBCUS survey to ascertain blood collection and transfusion data. Responses were compiled, and national estimates were calculated for the number of units of blood and blood components collected, distributed, transfused, and outdated in 2021. Weighting and imputation were applied to account for non-responses and missing data, respectively. Survey response rates were 92.5% (49/53) for community-based blood centers, 74.7% (62/83) for hospital-based blood centers, and 76.3% (2102/2754) for transfusing hospitals. Overall, 11,784,000 (95% confidence interval [CI], 11,392,000-12,177,000) whole blood and apheresis red blood cell (RBC) units were collected in 2021, a 1.7% increase from 2019; 10,764,000 (95% CI, 10,357,000-11,171,000) whole blood-derived and apheresis RBC units were transfused, a 0.8% decrease. Total platelet units distributed increased by 0.8%; platelet units transfused decreased by 3.0%; plasma units distributed increased by 16.2%; and plasma units transfused increased by 1.4%. The 2021 NBCUS findings demonstrate a stabilization in U.S. blood collections and transfusions, suggesting a plateau has been reached for both.

Hepatitis B, C And Hiv Exposure On Nat And Clia Blood Examination Methods At Regional Blood Centre Abbottabad.

Blood transfusion is a lifesaving method in clinical emergencies. Despite various preventive measures, the spread of Hepatitis B, C and HIV remains a big issue in Pakistan. This study was done to describe transfusion transmitted diseases using NAT and CLIA techniques, on exposure to these viruses. This study was conducted from 1st April to 25th August 2022. A descriptive study was done along with univariate analysis. The data was obtained from the regional blood centre in Abbottabad and it consists of reactive and non-reactive cases of NAT and CLIA in the sample size of 6233 donors. Data was collected from donors, and selected according to predefined criteria. In 6233 samples, 53 were reactive for either Hepatitis B, C or HIV. Forty-seven were reactive with both CLIA and NAT. 6 were reactive with NAT only and 6107 were non-reactive. NAT yield detected in this study is 0.096%. (1:1039 donations). It implies that NAT should be the preferred method for screening in blood banks.

Survey in Iranian Malaria Blood Donation Deferral: Laboratory Evaluation in Malaria Blood Donation Deferral in the Iranian Blood Centers

Introduction: Transfusion-transmitted malaria (TTM), from a malaria infected donor, is an accidental Plasmodium infection, which is one of the concerns of blood transfusion issue in the world. Countries have adopted different strategies for donor selection and improving criteria to overcome these concerns, In the Iranian Blood Transfusion Organization (IBTO), donors who refer to blood transfusion centers after registration are screened by the physicians based on interview and examination. This prevention due to the possibility of malaria infection is called malaria donor deferral strategy.
 Methods: In this study 248 malaria blood donation deferral samples were selected and evaluated by microscopic, serological and molecular methods, after completing the questionnaire.
 Results: The results of the survey of the questionnaires showed that 30 cases were deferred from donating blood due to having a history of malaria infection. In microscopic examination, Plasmodium ring was observed in 2 samples and 2 samples were also reported as suspicious. In serological examination, 23 cases (9.27%) were reported positive. All cases were reported negative for the presence of malaria parasite DNA.
 Conclusions: The adoption of TTM prevention strategies depends on the malaria endemicity of the geographical area. According to the IBTO instructions, donors are examined and interviewed by a blood transfusion physician’s and owning to traveling or residency in endemic area or malaria infection, deferred temporary or permanently.
 Recent study reveal that the strategy of donor selection and deferral in the IBTO, with little residual risk of malaria transmitting, is sufficient to prevent the occurrence of TTM in Iran.

Whole blood derived and apheresis platelets: Opinions and preferences-the results of a national survey of blood collectors.

Currently greater than 94% of the US platelet supply is collected by apheresis. A survey to determine the attitudes of members of America's Blood Centers (ABC) toward whole blood derived (WBD) platelets was designed in light of current platelet supply issues. An on-line survey was distributed to medical directors of the 47 ABC members. Responses were received from 44/47 (94%) ABC members. There were 15/43 (35%) centers that are currently providing WBD platelets. Seventy percent of the respondents agreed or agreed strongly that WBD and apheresis platelets were clinically equivalent, with approximately 16% indicating that they did not have an opinion on their equivalency and 14% indicating that they were not clinically equivalent. Forty-four percent of respondents felt that their customers would agree or strongly agree that these products are clinically equivalent, while 26% felt that their customers did not know or were neutral on clinical equivalency. The main barrier to WBD platelet implementation was logistic/inventory management issues, followed by bacterial contamination risk mitigation. There were 21/43 (49%) respondents who indicated they are not considering producing WBD platelets to mitigate shortages. Respondents indicated they might begin producing WBD platelets if there was evidence of increasing customer demand, increased reimbursement, inability to supply apheresis platelets, if pathogen reduction became available for WBD platelets, if the platelet shortage worsened. The majority of blood collectors consider WBD platelets clinically equivalent to apheresis, however wider adoption of WBD platelets is still hindered by challenges with logistics and inventory management.

SEROPOSITIVITY OF HEPATITIS C VIRUS INFECTION AMONG BLOOD DONORS AT A TERTIARY CARE CENTER IN WESTERN RAJASTHAN

Background & Objectives: The HCV epidemic is one of the largest public health crises of the 21st century, which has evolved from a mysterious illness to a global pandemic in less than 20 years. The purpose of this study is to estimate the seropositivity of HCVinfection among blood donors at our blood centre in Western Rajasthan. Methods: ARetrospective study of all donations from January 2022 to November 2022 was conducted for the seropositivity of HCV among the blood donors. A total of 41167 donations were analyzed for seropositivity, data were collected in Excel data sheet and analyzed using statistical calculations by IBM SPSS statistical software platform version 26. Seropositivity rate was calculated, chi square test was applied to test the signicance. Results: Out of the total 41167 donors tested for HCV infection, 91(0.22%) were found to be HCV seropositive. Conclusion: Strict blood donor screening, encouraging people to donate blood freely at regular intervals and widespread Hepatitis C immunization are always to reduce the occurrence of transfusion-transmitted infections. Although it will be challenging, we can still achieve our goal of having all blood donations in India.

Seroprevalence of transfusion- transmissible infections by type and their distribution across gender in blood donors, a regional blood center study, Pakistan.

Objective: To determine the prevalence and distribution by gender of Transfusion transmissible infections (TTIs) in blood donors. Study Design: Cross-sectional study Setting: Department of Community Medicine, G.M.C. Period: July 18, 2022 to November 18, 2022. Material & Methods: The data collecting tool was a structured proforma. A sample of 3329 was calculated with a 0.71% margin of error, a 95% confidence level, and an expected prevalence of TTIs of 4.61%. Consecutive non probability sampling technique used. Nominal variables were gender, type of donors, presence of TTIs and types of TTIs. Counts and percentages with 95% confidence intervals were used to describe the prevalence and distribution. Chi-square goodness of fit was used to compare expected values with observed values. SPSS version 21 was used for data analysis. Results: Out of sample of 3329, TTIs positive cases were 174 (5.22%) with 95% CI of 4.51- 5.93%. All the positive cases were males. The prevalence for Hepatitis B, Hepatitis C, HIV, Syphilis, and Malaria was 2.2%, 0.9%, 0.3%, 1.9%, and 0.1% respectively. Our observed values for Hepatitis B&C, HIV and malaria were not statistically significantly different from expected values except for syphilis. Conclusion: Prevalence of TTIs was 5.22% with significantly higher prevalence of syphilis as compared to expected prevalence.

Donor’s perspectives on blood donation and challenges of National Blood Center, Yangon, during the COVID-19 pandemic

Background: The ongoing COVID-19 pandemic is causing major disruption at all levels of healthcare services, including blood bank services globally. The donors’ knowledge, attitudes, beliefs, and behaviors regarding blood donation in Myanmar are needed to be considered. Hence, we studied the perspectives of blood donors on their donation and the challenges faced by the National Blood Centre, Yangon (NBC), during the COVID-19 pandemic. Methods: We conducted the cross-sectional descriptive study using mixed methods among blood donors aged 20 years and above for quantitative approach and among three purposively selected blood bank experts for key informant interviews of qualitative portion. Results: Of the 240 donors, the mean age was 36.41±10.83 years, and the male-to-female ratio was 1.24:1. Overall, regarding blood donation, 57.1% had favorable knowledge, 59.2% had favorable attitude, and 31.3% had regular voluntary practice. The higher-income donors had more favorable knowledge (p=0.013). Male donors (p=0.037), donors aged 50 years and above (p<0.001), and who with favorable knowledge (p=0.002) had regular voluntary practice. The more knowledge and positive attitude the donors had, the more times they donated blood. Thematic analysis identified five key themes and during pandemic, NBC encountered reduced blood supply and demand, communication problems with donors, human resources shortage, poor adherence to safety precautions of COVID-19 among donors and staff, and difficulty in arrangement of continuous consumable supply and maintenance as main challenges. Conclusions: Policymakers and medical directors should have proper plans and policies to raise awareness, mobilize regular voluntary donors, especially youth and repeated donors, and recruit potential donors.

A reference interval study of ferritin and transferrin levels in donors from two blood centers.

Blood donors not only save the lives of patients but also play an important role in the development of medical and health services. Therefore, it is particularly important to pay attention to the blood health of blood donors who are at a high risk of iron deficiency. Detection of serum ferritin and transferrin is an important basis for the diagnosis of iron deficiency anemia. However, to the best of our knowledge, the levels of serum ferritin and transferrin, and the influencing factors, such as age and type of donation, in blood donors have not been clarified. In the present study, the serum ferritin and transferrin levels of donors from two blood centers were investigated. Demographic data were collected from the donors, and their serum ferritin and transferrin levels were tested. A total of 1,817 donors were enrolled and were eligible for evaluation. Reference intervals (RIs) for ferritin and transferrin were obtained from blood donors, and it was revealed that the ferritin and transferrin levels of blood donors were associated with age. Furthermore, serum transferrin levels were associated with the type of donation; the serum transferrin RI level was significantly higher in platelet-only donors compared with in whole blood donors. It was also demonstrated that ferritin levels were negatively associated with transferrin levels. The present study identified RIs for ferritin and transferrin levels in blood donors, and indicated that age and type of donation were important factors affecting ferritin and transferrin levels in blood donors. These findings may prove useful for blood donation recruitment and screening strategies in China, and could promote the health of blood donors.

An unmanned emergency blood dispatch system based on an early prediction and fast delivery strategy: Design and development study

Background and objectiveFor severe trauma patients, hemorrhage is the most common cause of medically preventable deaths. Early transfusion is beneficial to major hemorrhagic patients. However, the early supply of emergency blood products for major hemorrhagic patients is still a major problem in many areas. The aim of this study was to design and develop an unmanned emergency blood dispatch system for the fast delivery of blood resources and rapid emergency response to trauma events, especially those with mass hemorrhagic trauma patients and those occurred in remote areas. MethodsBased on the process of emergency medical services for trauma patients, we introduced unmanned aerial vehicle (UAV) and designed the main flowchart of the dispatch system, which combines an emergency transfusion prediction model and UAV-related dispatch algorithms to improve first aid efficiency and quality. The system identifies patients in need of emergency transfusion through a multidimensional prediction model. Then, by analyzing the blood center, hospitals and UAV stations nearby, the system recommends the patient's transfer destination for emergency transfusion and dispatch schemes of UAVs and trucks for a fast supply of blood products. Simulation experiments of urban and rural scenarios were conducted to evaluate the proposed system. ResultsThe developed emergency transfusion prediction model of the proposed system achieves a higher AUROC value of 0.8453 than a classical transfusion prediction score. In the urban experiment, by adopting the proposed system, the average wait time per patient decreased from 32 to 18 min, and the total time decreased from 42 to 29 min. Owing to the combination of the prediction and the fast delivery function, the proposed system took 4 and 11 min less wait time than the strategy with only the prediction function and the strategy with only the fast delivery function, respectively. In the rural experiment, for trauma patients requiring an emergency transfusion at 4 locations, the wait time for transfusion under the proposed system was 16.54, 17.08, 38.70 and 46.00 min less than that under the conventional strategy. The health status-related score increased by 6.9%, 0.9%, 19.1% and 36.7%, respectively. ConclusionsExperimental results demonstrate that the proposed system works well with a faster blood supply speed for severe hemorrhagic patients and better health status. With the assistance of the system, emergency doctors at the scene of an injury are able to comprehensively analyze patients’ status and the surrounding rescue conditions and then make decisions, especially when encountering mass casualties or casualties in remote areas.

PATTERNS OF SEROPREVALENCE FOR TRANSFUSION-TRANSMISSIBLE INFECTIONS AMONG BLOOD DONORS IN A BLOOD CENTRE OF NORTHEAST INDIA

Introduction: Transfusion– Transmissible Infections (TTIs) are the infections resulting from the introduction of a pathogen into a person through blood transfusion. In an attempt to mitigate the inherent risk of TTIs, the demographic information of blood donors including knowledge on local prevalence of infections and its pattern in the donor population is important for formulating recruitment strategies and planning other precautionary measures. Materials & Methods: This cross-sectional study was conducted in the Blood Centre, Jawaharlal Nehru Institute of Medical Sciences, Imphal between January 2019 and December 2022. All donated blood units were tested for the mandatory TTI markers for HIV 1 & 2, Hepatitis B, Hepatitis C, Syphilis and Malarial parasite. The prevalence and patterns of seropositivity for TTIs were studied based on the donor demographic characteristics such as donation type, gender and age group. Results: The overall seroprevalence among blood donors (n=31,563) was 1.79%. The seroprevalence was lower among voluntary donors (1.08%) than the replacement donors (2.10%). Seropositivities among female and male donors were 0.79% and 1.93% respectively. The lowest TTI seropositivity was seen among female voluntary donors (0.59%) and highest among male replacement donors (2.24%). The seroprevalence for specic TTI markers among the blood donors were 0.15% for HIV; 0.57% for HBV; 0.93% for HCV; 0.14% for Syphilis and no donor was found positive for Malaria. The frequency of TTI seropositivity was increased with increase in the age groups of donors in both sexes. There were 9 (0.029%) donors who had co-infection of TTIs. The patterns of TTI markers for co-infections were HCV+HIV=3; HCV+HBV=3; HCV+Syphilis=2 and HIV+ Syphilis=1. Conclusion: The measures to provide safe blood may include collection of blood from the targeted low risk donor population, using more sensitive testing methods, implementing pathogen reduction technologies and other public health measures.

Serological characteristics and molecular mechanism of an individual with p phenotype

To analyze the serological characteristics and molecular mechanism for an individual with p phenotype. An individual with p phenotype upon blood group identification at Jiaxing Blood Center in May 2021 was analyzed. ABO, RhD and P1PK blood groups and irregular antibodies in her serum were identified using conventional serological methods. The encoding region of α1, 4-galactosyltransferase gene (A4GALT) encoding P1 and Pk antigens was analyzed by polymerase chain reaction-sequence-based typing (PCR-SBT). The individual was A group, RhD positive and had a p phenotype of the P1PK blood group system. Anti-PP1Pk was discovered in her serum. Sequencing analysis revealed that she has harbored a homozygous c.343A>T variant of the A4GALT gene. The homozygous c.343A>T variant of the A4GALT gene probably underlay the p phenotype in this individual.

A randomised controlled trial of long NY-ESO-1 peptide-pulsed autologous dendritic cells with or without alpha-galactosylceramide in high-risk melanoma

AimWe have previously reported that polyfunctional T cell responses can be induced to the cancer testis antigen NY-ESO-1 in melanoma patients injected with mature autologous monocyte-derived dendritic cells (DCs) loaded with long NY-ESO-1-derived peptides together with α-galactosylceramide (α-GalCer), an agonist for type 1 Natural Killer T (NKT) cells.ObjectiveTo assess whether inclusion of α-GalCer in autologous NY-ESO-1 long peptide-pulsed DC vaccines (DCV + α-GalCer) improves T cell responses when compared to peptide-pulsed DC vaccines without α-GalCer (DCV).Design, setting and participantsSingle-centre blinded randomised controlled trial in patients ≥ 18 years old with histologically confirmed, fully resected stage II–IV malignant cutaneous melanoma, conducted between July 2015 and June 2018 at the Wellington Blood and Cancer Centre of the Capital and Coast District Health Board.InterventionsStage I. Patients were randomised to two cycles of DCV or DCV + α-GalCer (intravenous dose of 10 × 106 cells, interval of 28 days). Stage II. Patients assigned to DCV + α-GalCer were randomised to two further cycles of DCV + α-GalCer or observation, while patients initially assigned to DCV crossed over to two cycles of DCV + α-GalCer.Outcome measuresPrimary: Area under the curve (AUC) of mean NY-ESO-1-specific T cell count detected by ex vivo IFN-γ ELISpot in pre- and post-treatment blood samples, compared between treatment arms at Stage I. Secondary: Proportion of responders in each arm at Stage I; NKT cell count in each arm at Stage I; serum cytokine levels at Stage I; adverse events Stage I; T cell count for DCV + α-GalCer versus observation at Stage II, T cell count before versus after cross-over.ResultsThirty-eight patients gave written informed consent; 5 were excluded before randomisation due to progressive disease or incomplete leukapheresis, 17 were assigned to DCV, and 16 to DCV + α-GalCer. The vaccines were well tolerated and associated with increases in mean total T cell count, predominantly CD4+ T cells, but the difference between the treatment arms was not statistically significant (difference − 6.85, 95% confidence interval, − 21.65 to 7.92; P = 0.36). No significant improvements in T cell response were associated with DCV + α-GalCer with increased dosing, or in the cross-over. However, the NKT cell response to α-GalCer-loaded vaccines was limited compared to previous studies, with mean circulating NKT cell levels not significantly increased in the DCV + α-GalCer arm and no significant differences in cytokine response between the treatment arms.ConclusionsA high population coverage of NY-ESO-1-specific T cell responses was achieved with a good safety profile, but we failed to demonstrate that loading with α-GalCer provided an additional advantage to the T cell response with this cellular vaccine design. Clinical trial registration: ACTRN12612001101875. Funded by the Health Research Council of New Zealand.

Personalized medicine comes to a blood center near you

Personalized medicine comes to a blood center near you

Incidence of Hepatitis B Due to Multiple Transfusions in Patients of β-Thalassemia Major

β-Thalassemia is one of the most prevalent childhood hemolytic disorders. Multiple blood transfusions of unscreened blood can result in infection transmission. After many transfusions, Hepatitis B infection in thalassemia patients was reported. Objective: To determine the incidence of Hepatitis B in β-thalassemia major patients, associated with multiple blood transfusion strategies. Methods: This cross-sectional study was executed in Pediatric department of DHQ teaching hospital Dera Ismail khan with the collaboration of the Regional Blood center, and comprised 360 patients, diagnosed with β-Thalassemia Major and maintained on multiple transfusions. Results: The average weight of the subjects was 43.50+18.76 Kg and their mean age was 13.10+2.1 years. The significantly high population of the patients (p<0.05) was not immunized against Hepatitis B (73.88%), while only 26.66% (94/360) were immunized. The patients having less than 10, 11-20 and more than 20 transfusions per annum comprised 72 (20%), 157 (43.61%) and 131 (36.38%) patients, respectively. The affected patients had significantly altered hematological parameters (p<0.05). The highest number of β-Thalassemia Major patients affected with Hepatitis B belonged to the Group having more than 25 transfusions of blood annually, with an incidence rate of 11.53. Conclusions: The greatest risk factor for Hepatitis B infection in β-thalassemia major patients is concluded to be multiple blood transfusions. It was also found that a huge population of Thalassemia patients was not immunized against HBV despite the severe risk. Therefore, health education and awareness campaigns are needed for the significance of Hepatitis B immunization and transfusion of screened blood.

Haplotype-dependent HLA-DRB1-DQB1 susceptibility to occult HBV infection in Xi'an Han population.

Occult hepatitis B virus (HBV) infection (OBI) is primarily characterized by the persistence of HBV-DNA in the liver tissues and/or in the serum without detectable HBsAg. Human leukocyte antigen (HLA) polymorphisms have been found to be strongly associated with HBV in different ethnic backgrounds. The association of HLA-DRB1-DQB1 haplotypes with OBI has not been previously reported in China. The aim of this study was to identify the potential association of HLA-DRB1-DQB1 haplotypes that may be involved in OBI genetic susceptibility. A case-control study was conducted between 107 OBI subjects and 280 healthy controls from the blood donors in the Shaanxi Province Blood Center. The HLA-DRB1, DQB1 loci were genotyped using polymerase chain reaction-sequence based typing (PCR-SBT). Based on the genotype data of the two loci, haplotype estimation was performed. HLA-DRB1*07:01-DQB1*02:02 (pc=0.344 × 10-3 , OR=3.489, 95%CI=2.000-6.088) and HLA-DRB1*09:01-DQB1*03:03 (pc=0.02, OR=2.370, 95%CI=1.450-3.873) serve as the possible risk and susceptibility haplotypes for OBI in Xi'an Han after Bonferroni correction. This study demonstrated that HLA II haplotypes were significantly associated with OBI in the Xi'an Han population. To the best of our knowledge, this is the first study to associate HLA-DRB1-DQB1 haplotypes with OBI, which can provide valuable insights into the relationship between the various genetic factors and immune responses in the Xi'an population. The findings can also form the basis for future studies about the role of HLA in OBI.