THE SCIENTIFIC JOURNAL OF IRANIAN BLOOD TRANSFUSION ORGANIZATION (KHOON)
Year:2005 | Volume:2 | Issue:5|Papers Count:15

Background and Objectives The co-existence of recipient’s and donors hematopoietic systems after allogeneic marrow transplantation is called mixed chimerism. Chimerism analysis provides a national method of assessing the ability of different conditioning regimens, graft-versus-host disease (GVHD), prophylactic regimens, and cellular therapy to promote engraftment.Materials and Methods The association of mixed chimerism with acute graft-versus-host disease (GVHD), disease recurrence, survival, and relapse free survival was investigated in 91 patients 12 and 79 of whom underwent either bone or peripheral blood HLA-identical marrow transplantation respectively. Chimerism was assessed using multiplex amplification of shorty tandem repeats (STR-PCR). Cases included thalassemics (19 subjects), AML (29), ALL (20), CML (18) and others (5). Median age was 21 (age range of 3-50). There were 38 females (41.8%) and 53 males (58.2%). Conditioning was busulfan plus cyclophosphamide in 34 patients, busulfan plus fludarabin in 51 patients and busulfan plus fludarabin plus anti-thymocyte globulin in 6 patients. Median time of follow up was 13 months. Data was analyzed using SPSS statistical software.Results On day 30 after transplantation, mixed chimerism (MC) was observed in 15 patients (16.5%), complete donor chimerism (CC) in 72 patients (79%), and no chimerism in 4 patients. The incidence of acute GVHD was significantly lower in mixed chimeras than in complete chimeras (p=0.01) but there was no significant difference in acute GVHD grade (I, II vs. III, IV) between two groups. The incidence of relapse and overall survival were 17.6% and 88.9% respectively showing no significant difference between MC and CC. Relapse free survival was 80.2% and not significantly different between two groups.ConclusionsDespite some previous reports, we found no significant difference in survival and relapse rate between MC and CC.  

Background and Objectives Human cytomegalovirus (HCMV) is a DNA virus, approximately 200nm in diameter, belonging to the herpes virus family. CMV infection in immunocompromised patients including organ transplantation recipients, patients with AIDS patients under immunosuppressive therapy, and in developing fetus may result in either localized or disseminated diseases. Patients are at risk of both primary CMV infection and reactivation of latent infection. CMV can be transmitted through blood transfusion and organ transplantation. Materials and Methods In this descriptive study, 62 recipients of kidney transplant (26 females, 41.9% and 36 males, 58.1%) ranging from 2-58 years of age (mean 34±15) were analysed to detect CMV antibodies by ELISA technique; CMV antigen was also evaluated by Indirect Immunofluorescence Technique. Results All patients were CMV IgG positive, 10 (16.1%) were CMV IgM positive and 7 (11.4%) were at borderline. 23 (37.1%) of recipients were CMV Ag positive. Statistical analysis showed no relation between CMV Ab and CMV Ag. Conclusions In spite of the presence of anti-CMV IgG and IgM antibodies, antigenemia appears in several patients. There is not a strong correlation between antibodies against cytomegalovirus and the detection of CMV antigen in patients with acute infections.  

Background and Objectives Chronic myelogenesis leukemia (CML) is a chronic myeloproliferative disorder resulting from a specific mutation in a pluripotent stem cell. The association of philadelphia chromosome with this disorder was described in 1973. Subsequently, the BCR-ABL fusion gene and its product which is a tyrosin kinase inhibiting apoptosis were introduced. The treatment of choice for these patients is BMT as well as the new molecular treatment of imatinib mesylate. The present study was designed in order to compare the rate of expression of the BCR-ABL gene in patients who had undergone treatment by bone marrow transplantation with those treated by imatimib.  Materials and Methods Expression of BCR-ABL gene was measured in 34 patients; 17 patients were treated with BMT and 17 with imatinib mesylate using quantitative PCR on a light cycler instrument.  Results The results obtained in this preliminary study demonstrates that rate of gene expression in patients treated with imatinib mesylate for more than 8 months was similar to that found in patients treated with BMT who were in relatively stable conditions. Conclusions This finding may be an indication that imatinib mesylate as a molecular inhibitor can have the same effect as BMT but with less adverse effects. Clearly, definite conclusions require more extensive studies on larger number of patients.  

Background and Objectives Hepatitis E virus (HEV) causes enterically transmitted acute viral hepatitis. Hepatitis E virus infection spreads by the fecal-oral route. However, blood donors might transmit HEV during the transient phase of viremia that precedes the onset of symptoms. To our knowledge, few reports on the prevalence of Hepatitis E in Iranian blood donors exist. The aim of this study was to evaluate the frequency of anti-HEV among male blood donors in Tabriz.  Materials and Methods This cross-sectional study was carried out between July and August 2004 in Tabriz. Serum samples were collected from 399 voluntary male blood donors and tested for anti-HEV IgG using EIA. All the subjects were negative for anti-HIV, anti-HBV and anti-HCV antibodies.  Results The prevalence of anti-HEV IgG among 399 blood donors was 7.8% (95% CI: 5.2%-10.4%). Seropositive subjects had a mean of 40.7±12.4 SD. Donors who were 40 and older (14 out of 83) had significantly higher seroprevalence than those who were younger than 40 (17 of 316) (p<0.001). 3 of 11 illiterate donors had anti-HEV IgG. Among educated donors 10 of 88, 14 of 206 and 4 of 94 in elementary, intermediate and college levels were positive respectively (p<0.025). Conclusions These findings demonstrate the high seropositive rate of anti-HEV among male blood donors in Iran that is compatible with endemicity of this virus in our country.  

Background and Objectives Conditions for preparation and storage of platelets for transfusion purposes may lead to platelet activation which in turn contributes to decreased ability of stored platelets to function and to survive in vivo after transfusion as compared with freshly prepared platelets. We investigated platelet membrane expression of CD62P, CD63 in platelet stored for up to 3 days under standard blood banking conditions.  Materials and Methods Twenty-four platelet units prepared by platelet-rich-plasma and platelet concentrates were evaluated during storage for markers CD62P, CD63 and pH. Results During storage for up to 3 days platelet units displayed no significant pH (p>0.05). During storage for up to 3 days (days 1 and 3) platelet units were significant in the CD62P and CD63 expressions as compared with day 0 (p<0.05). Conclusions Storage of platelet concentrates causes activated platelets. Moreover, these markers (CD62P and CD63) can act as useful in vitro means in the quality control of platelet components.  

Background and Objectives The most important challenge in selecting suitable assays for the detection of anti-HCV is sensitivity. In this study, 20 assays (EIA method) were compared with each other and with anti-HCV 3.0 Enhanced SAV (Ortho Company production) as the reference assay recommended by WHO. Materials and Methods 20 kits were compared by 3 to 4 seroconversion and 2 to 3 performance panels. The relative sensitivity of kits was calculated based on WHO recommendations.  Results In seroconversion panels, relative sensitivity of 3 assays was the same as the reference assay and 5 assays showed lower relative sensitivity, but the differences between these five kits and the reference assay appeared just in two samples. In performance panels, two assays came out to be the same as the reference assay and the other 5 assays detected just 2 samples to have a level lower than anti-HCV 3. In all seroconversion and performance panels, the best results were obtained by ETI-AB-HCH-K4 (146) (Diasorin), Monalisa Anti-HCV plus Version 2 (BIO-RAD), Hepanostica Anti-HCV ULTRA (BIOMERIEUX), Anti-HCV-EIA 3rd (Avicenna Medial Center), and HCV AB (DIA PRO). Conclusions For improvement of blood safety, the assay with high sensitivity is recommended to be used, and the samples with weak positive reactions especially in seroconversion and low titer performance panels should be given more attention.  

Background and Objectives Viral hepatitis B is a dangerous disease with high mortality and morbidity rate in the world. It has been proved that its prevalence in different areas depends on risk behaviors and people’s awareness level. This paper was prepared to detect the risk factors of hepatitis B in blood donors in Isfahan province.  Materials and Methods In a cross-sectional study, 39 seropositive blood donors and 261 seronegeative ones in 2004 were studied. HBsAg was examined via ELISA. Standard hepatitis B risk factor questionnaires were completed for all of the samples and the prevalence of each risk factor in case and control subjects was compared through X2 test, using SPSS-10 software with p<0.05. Results This study indicated that the history of surgeries, use of shared razors, jaundice of mother, presence of HBsAg+ patients and drug addicts in families were statistically significant in the two groups. There was not any hemodialysis history, accident of needle sticks and needle sharing by drug addicts. Conclusions Since the relative frequency of surgery history in the two groups was significantly different, attending to hospital and operation room hygine seems to be very important. Moreover, since hepatitis B can be prevented with education and vaccination, the families of  HBsAg+ patients and drug addicts should be encouraged to use education and vaccination. Using the results of this study, it is necessary to pay attention to hospitals and raise people awareness about hepatitis B transmission routes and vaccination of high risk individuals.  

Background and Objectives The prevalence of GBV-C and HGV in blood donor populations in developd countries based on HGV RNA detection and anti-E2 screening ranges from 1 to 5 and 3 to 14% respectively. The aim of this study was to investigate seroepidemiologic hepatitis G virus (HGV) in blood donors, haemodialysis patients, haemophiliacs, and β thalassemics with a history of liver disease by Elisa technique. Materials and Methods In this descriptive study, blood samples of 330 volunteer blood donors, 44 haemodialysis patients, 16 haemophiliacs, and 40 β major thalassemics with a history of liver disease were studied by Elisa technique for their seroepidemiologic status of hepatitis G virus and their past record of HGV infection. For data analysis, Chi-square, Fisher exact test, and SPSS version 11.5 were used. Results This study showed that out of 330 healthy blood donors 14(4.2%), out of 44 haemodialysis patients 10(22.7%), out of 16 haemophiliacs 5 (30.3%) and out of 40 β thalassemics 10 (25%) were positive for HGV-anti-E2. These data are significant evidence for HGV to be considered as a transfusion-transmitted infection. The prevalence of anti-HGV and anti-HCV (co-infection) was found to involve 10 (30.3%) of haemodialysis patients, 4 (28.6%) of haemophiliacs and 9 (23.7%) of β thalassemics. It was also found that 1 (8.3%) of haemodialysis patients, 1 (33.3%) of haemophiliacs, and 1 (50%) of β thalassemics were infected with anti-HGV and HBsAg co-infection. Conclusions The prevalence of HGV was high in multitransfused individuals including haemodialysis patients, haemophiliacs, and thalassaemics. Therefore, HGV was a transfusion-transmittable agent. Co-infection of anti-HGV with HCV was observed in viruses. It is recommended that further studies focus on evaluating sexual and vertical transmission routes so as to cast light on relatively high rate of HGV in donor population.

Background and Objectives Hemolytic transfusion reactions have been one of the most common causes of transfusion related mortalities and morbidities. Increased vigilance and use of newer technologies could lead in decreased rate of complications.  Case A 19-year-old man with a broken leg, under anesthesia and surgery, received 2 packs of RBCs. Afterwards, he was admitted in the intensive care unit of the hospital for supportive care. Later assessments revealed that the transfused blood, though confirmed by the hospital blood bank, had not been really isogroup.  Conclusions Transfusion related medical errors are still inducing a considerable rate of mortality and morbidity in our health system. Systematic approachesn (including enhancement of the role of hospital transfusion committees) to lower these complications could lead in decreased rate of errors.