THE SCIENTIFIC JOURNAL OF IRANIAN BLOOD TRANSFUSION ORGANIZATION (KHOON)
Year:2005 | Volume:2 | Issue:3|Papers Count:12

Background and Objectives Although the French-American-British (FAB) Classification system is the basis for the diagnosis and treatment of AML, it has its own limitations. During recent years immunophenotyping by flow cytometry is widely used for the identification of AMLS subtypes. Immunophenotyping has been especially helpful in discrimination of AML with monocytic differentiation (M4-M5) from nonmonocytic subtypes (M0- M1- M2- M3- M6- M7). However several studies have indicated that CD14 mostly is negative when applied to leukemias with monocyte differentiation.Materials and MethodsSome studies have shown that CD64 (FCγRI) is an early and specific myelo-monoid marker. In this study we evaluated CD14 and CD64 antibodies to identify cells of monocytic lineage in 216 cases of AML who were referred to IBTO flow cytometry laboratory. These monoclonal antibodies prepared by DAKO Company and were conjugated with Phyco Erythrin. The samples were analysed by Epics-x1 Flow cytometer. The markers were considered positive if 20% or more of the cells expressed it. The Chi-square test was also used in SPSS software.ResultsResults revealed that CD64 was highty specific (88%) and sensitive (67%) and CD14 was highty specific (96%) but not sensitive (31%) with >95% confidence rate. These results are compatible with other studies.ConclusionsFinally because of high sensitivity of CD64, it should be considered in all of immunophenotyping protocols as a sensitive and specific marker for monoid cells.

Background and Objectives The immunity system of thalassemics cause of different reasons faces dysfunction. So they are susceptible to recurrent infections. One of these reasons pertains to deficiency in phagocytosis, chemotaxis, and bacterial killing ability neutrophils. As there are several reports about decline in neutrophilic functions in such patients, we aimed at studying phagocytosis and candida killing in major thalassemics.Materials and MethodsIn this study, we analyzed blood samples drawn randomly from 30 patients with thalassemia major (16 splenectomized), and 30 healthy subjects as control group without any familial background of the disease. We evaluated phagocytosis and candida killing in these groups.ResultsOur findings showed that there is no relationship between sex and age with neutrophil function in the patients. There is a significant difference in phagocytosis (p<0.1) and killing ability between the patient group and control group (p<0.0001).ConclusionsSince phagocytosis and candida killing are of lowest activity in patients than in the control group, there may be relative deficiency in these patients’ neutrophils function.

Background and Objectives Screening the blood donors for serological markers reduced the incidence of transfusiontransmitted infections especially post-transfusion hepatitis C. However, there remains residual risk due to pre-seroconversion period. HCV RNA (PCR) of blood donations reduced the residual risk of transfusion-transmitted HCV infection. In this study, blood donations were screened for HCV RNA by RT-PCR method.Materials and MethodsAn extra plasma sample was collected from 1026 blood donors. 1000 out of 1026 samples were negative for HBsAg, anti-HCV (EIA, third generation), anti-HIV and RPR. Every 5 samples were pooled. The sensitivity of HCV-RNA detection by RT-PCR method was 380 geq/ml according to Proficiency VQC panel. 1000 donations in 200 pools were tested.ResultsFalse reactivity of samples considered positive accounts for 5.5% of cases, and 5.5% were invalid due to non-specilic bands. 6% of the pools were false-positive. A false positive result was defined as positive on initial testing but negative on repeat single testing. However, all of the samples were negative for HCV RNA by RT-PCR method.ConclusionsNo sample was found to be serologically negative and HCV RNA positive. However, further studies are recommended for further clarification.

Background and Objectives Blood group antigens include more than 260 antigens on the erythrocyte cell membrane, forming 24 different blood group systems. These can be categorized in 11 major systems which account for 172 of the antigens. Incompatibility of some of these antigens, especially in multiple transfused patients, results in hemolytic reactions. Although intermediate thalassemics need fewer blood transfusions than major ones, alloimmunization is more frequent in the former. This can be due to the different frequenct rates of blood group phenotypes in intermediate thalassemics as compared with healthy people.Materials and MethodsRed blood cell antigen typing was done in 39 intermediate thalassemics and 150 healthy blood donors for Rh, Kidd, MNSs, Lutheran and Duffy blood systems. K and M antigens had different frequency rates in both groups (p<0.01, p<0.0005) showing higher frequency in patients.ResultsComplementary studies are recommended to be performed in order to evaluate high-risk alloimmunization in intermediate thalassemias. Assessment of the frequency of other red blood cell antigens, antibody screening, and identification of alloantibodies in immunized intermediate thalassemics can be helpful in this regard.ConclusionsKantigen is very immunogenic; however its prevalence rafe is high among intermediate thalassaemics, but this contradiction can not be posed as the increasing cause of alloimmune reactions in such patients. Supplemental studies including screening and detection of posttransfusion created antibody types not only help in selecting the more appropriate blood type for thalassaemics but also help in justifying increasing alloimmune reactions in thalassaemics.

Background and Objectives Cytomegalovirus (CMV) causes infection in immunocompromised, transplant recipients and those who receive blood transfusion frequently. Latent and dormant CMV infection can be reactivated in immunocompromised patients and cause fulminant infection. Risk factors for primary CMV infection are blood transfusion (including clotting factors, etc.), recipients of infected transplants, hemodialysis, and the frequency of dialysis in a week. In order to evaluate the serologic status of hemodialysis patients in Labbafinejad Hospital, we have done this descriptive study.Materials and MethodsA descriptive study (cross-sectional) was designed in 54 hemodialysis patients in Labbafinejad Hospital. With ELISA technique and with RADIM kit, IgM and IgG titers were determined. Titers greater than 1.1 ISR were considered positive and less than 0.9 ISR negative. Titers between 0.9 ISR and 1.1 ISR were considered equivocal and deleted. After primary data collection procedure aiming at evaluating relationships between parameters, Chi-square test and Fishers exact test were used.ResultsIn our study 54 patients who regularly underwent hemodialysis were studied. Twenty-nine patients were male and 25 female with the age range of 53 ± 16. Mean dialysis length was 81.7± 69.4. In the time of evaluation, 49 patients (91%) were anti-CMV IgG positive and 10 were anti-CMV IgM positive. There was no relationship between the antibody titer and dialysis duration. There was found to be an indirect significant correlation between the CMV IgG titer and dialysis frequency (r=-0.31, P<0.024).ConclusionsTherefore, we recommend that every patient who was undergone hemodialysis receive blood products free of CMV.

Background and Objectives Human Parvovirus B19, the causative agent of fifth disease in childhood, lacks lipid envelop and is resistant to many physicochemical agents. B19 is a potential risk to hemophiliac patients receiving blood products. Materials and MethodsThe present research is a descriptive and cross-sectional study. To determine the prevalence of the corresponding antibody in patients with hemophilia A or B or Von Willbrand’s disease, we tested 180 hemophilia patients for anti B19 IgG. The results were compared with those of 400 age-matched controls subjects (male blood donors and children). SPSS version 10 and Chisquar were used for data analysis.ResultsThe overall prevalence of B19 IgG in the hemophilia patients was 74% (133/180) and in the control 56.5% (226/400, p<0.001).ConclusionsThese observations demonstrate that parvovirus B19 is frequently transmitted by blood products. Existing virus-inactivating methods do not prevent transmission.

Background and Objectives In this study our aim was to determine HLA-Class I and II antigens frequencies of Hamedani ethnic group. In addition to demographic studies and disease association, it has wide application in bone marrow donor registries.Materials and MethodsIn order to establish DNA-based HLA typing in central Laboratory of Iranian Blood Transfusion Organization, a comparison of serological and molecular (sequence specific primers “SSP”) methods for HLA-DRB has been performed. The study was descriptive and the populations under study were selected out of the native people of Hamadan; 100 healthy volunteer blood donors were chosen by questionnaire. 10ml heparinized and 3ml EDTA blood were collected from each selected donor. EDTA (PCR) samples were then frozen.ResultsN.I.H standard microlymphocytotoxicity and Nylon wool T and B cells separation was used for serological I and II typing. HLA-Class I plates were prepared from Iranian Blood Fractionation and Research Company and for Class II we used Biotest DR/DQ Typing Trays. PCR was done using “Roche high pure DNA extraction” Kit and HLA-DRBSSP (Biotest). The most and least frequent HLA-B antigens were B5 group (B51/B52) and B16 (38,39) respectively. Because of low resolution of HLA-DRB Kit, no significant difference was observed between serological and PCR methods. Although some blanks have been determined by PCR.ConclusionsThe HLA-DRB determination by PCR is mandatory for donor/recipient pairs (even sibling) for bone marrow transplantation; for donors it should be done by high resolution kits.

Background and Objectives To avoid laboratory errors in the detection of hemoglobinopathies, a control sample containing hemoglobin (Hb) A,F,S or C should run with each set of samples.The aim of this project was to prepare a lyophilized heme control for the cellulose acetate electrophoresis.Materials and MethodsAfter lysing the red blood cells, the hemolysate was centrifuged at 25000 rpm. The clear red supernatant was diluted with drabkin reagent to 20-30 gr/L and Hb was converted to cyanomethemoglobin. After adding sucrose and preservatives, the hemolysate was passed through milipore filter (0.45 µm) and then aliqouted and lyophilized.ResultsIn this project three heme control samples were prepared. The first sample contains Hbs A,F,D or G ,the second one contains Hbs A,S, and the third contains Hb A,F. Although the amount of potassium cyanide used is 10 times less than other methods , the stability is more than 6 months at 4oC; moreover, and the electrophoretic patterns have good resolution and the obtained CV and SD show good reproducibility.ConclusionsThe preparation method in this project is simple, reliable, cost effective and in comparison with other methods has less amount of potassium cyanide; therefore, it is safe for the laboratory staff.

Background and Objectives During pregnancy, irregular blood group antibodies originating either from earlier pregnancies or from blood transfusions may severely affect child health. In this report, a case of maternal alloimmunization to Kell antigen is described.CaseThe mother had a history of partial mole and four repeated intrauterine fetal death due to hydrops fetalis.ConclusionsScreening of irregular blood group antibodies revealed that she has anti-Kell with the titer of 1:4096. Also in genetic analysis, a C677T homozygous mutation of MTHFR gene was found, which could potentially enhance destructive effects of anti-Kell antibody. The described case emphasizes the importance of being informed about the presence of irregular blood group antibodies during pregnancy which may cause recurrent hydrops.