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Review Article
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Abstract:
ABO blood group incompatibility is not a contraindication for allogeneic hematopoietic stem cell transplantation (allo-HSCT). An increasing number of ABO-incompatible HSCT (ABOi-HSCT) procedures have been performed along with advances in donor selection over the years. Currently, whether the recipient-donor ABO incompatibility has detrimental effects on post-HSCT outcomes is a matter of debate. Discrepancies across studies referring to various graft sources, donor types, conditioning regimens, and the use of immunomodulators complicate interpretations of the clinical outcomes of ABOi-HSCT, such as transfusion requirements, graft-versus-host disease (GVHD), disease relapse, overall survival (OS), and non-relapse mortality (NRM). Isohemagglutinins (ISO) targeting red blood cell (RBC) antigens are associated with post-HSCT immunohematological complications, including hemolysis, passenger lymphocyte syndrome (PLS), and pure red cell aplasia (PRCA). Immunohematological events occur frequently and are sometimes difficult to handle in clinical practice. Therefore, it is necessary to form a deeper understanding on the mechanism and a comprehensive management scheme for recipients of ABOi-HSCT. In this review, we summarized literature of the impact of ABO incompatibility on post-HSCT outcomes and outlined important immune-mediated hematological events.
Abstract:
Since the advent of murine hybridomas, the emergence of a variety of monoclonal antibody (mAb) technologies has enabled the wide applications of murine monoclonal antibodies in medicine, life science, agronomy, and food science. Compared with murine monoclonal antibodies, rabbit monoclonal antibodies (RabmAbs) exhibit higher affinity, presenting with increased detection sensitivity and greater specificity for the particular structure of epitopes. This paper reviews the history, preparation techniques, advantages and disadvantages, current applications, and future perspectives for RabmAbs.
Original Article
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This research aims to analyze the research status, hotspots, and future development trends of spatially resolved transcriptomics (SRT). We obtained research publications on SRT from the Web of Science Core Collection (WoSCC) database and performed graph analyses with VOSviewer and OriginPro 2018. Included was a total of 2022 papers, involving 13234 researchers from 2105 institutions in 75 countries. The publication status and characteristics of countries, institutions, authors, and co-occurrence keywords were conducted by bibliometric analysis. The leaders in this field were the United States and Sweden, while China and India were the largest contributors among developing countries. SRT and single-cell sequencing are closely combined. The development of SRT itself, tumor-relevant research, and brain science, are the research hotspots of the present and foreseeable future. The development of bioinformatics facilitates the analytical applications of SRT. SRT and temporal dynamics should be closely combined. Future development in SRT is not only aimed at achieving high throughput and high resolution, but also dedicated to making it cost-effective, simple, rapid, and easy to use. Spatially resolved transcriptomics should be promoted from scientific research to clinical application as soon as possible in order to provide accurate diagnoses and individualized treatment for patients.
Abstract:
Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are life-threatening blood-borne infections that can be unintentionally transmitted in transfused blood products. Here, we optimized a method for detecting HBV, HCV, and HIV-1 in blood screening using magnetic nanoparticles (MNPs) and polymerase chain reaction (PCR)-chemiluminescence. Viral genomes were extracted from donated blood samples using MNPs. The isolated viral DNA and RNA were amplified in a one-step parallel reverse transcription-PCR (RT-PCR). HBV, HCV, and HIV-1 were detected using complementary nucleic acid probes and quantified using a chemiluminescent substrate. 10 422 donated blood samples were tested both with the above method and Roche Cobas TaqScreen MPX Test. The lengths of the amplified PCR products for HBV, HCV, and HIV-1 were 119 bp, 220 bp, and 174 bp, respectively, indicating that the extraction methods successfully separated high-quality viral genomes from the serum samples. The probes and reaction conditions used for the chemiluminescent detection of HBV, HCV, and HIV-1 genomes in unknown samples were empirically optimized. Of the 10 422 blood samples screened, 12 were HBV positive and 2 were HCV positive. These results were consistent with those of a parallel-controlled study using Roche Cobas TaqScreen MPX Test. The assay described here is fast, accurate, and sensitive for detecting HBV, HCV, and HIV, which runs in parallel and has broad implications for blood screening and epidemiological studies.
Abstract:
This study aimed to explore the distribution of the variant RHD genotypes in Jiangsu, China. A total of 108541 blood donor samples and 17 family members were tested from 2020 to 2021. A total of 121 RHD variants were found in 414 D negative samples and their families, including seven weak D, four partial, and three Del alleles. RHD*15 and RHD*DVI.3 were the prevalent D variant alleles in Jiangsu Province. Heterozygous alleles were identified (c.730G>C, c.1227G>A), and a case of unique intronic mutation was detected (c.802-41_802-38delCTCT). This study suggests that the frequency of RHD variants is crucial for establishing specific RHD genotyping strategies and can be applied in larger-scale routine tests for blood donors.
Abstract:
This study aims to investigate the clinical application value of serum total bilirubin, hemoglobin (Hb) and reticulocyte percentage (Ret%) combined with immunohematological tests in the diagnosis of ABO hemolytic disease of the newborn (ABO-HDN). A retrospective analysis of 503 neonatal blood samples of mothers with RhD(+) blood type O and neonates with RhD(+) blood type A/B, admitted to the Third Xiangya Hospital of Central South University from March 2020 to September 2021, was conducted. HDN was investigated with the elution test, indirect antiglubin test (IAT), and direct antiglubin test (DAT). The positive rate of the immunohematological tests for neonatal hemolysis, combined with the detection of serum total bilirubin, Hb and Ret%, was significantly higher than that of immunohematological tests for neonatal hemolysis alone (P<0.05). The elution test can be used as a gold standard to diagnose HDN. Neonates with blood type A had a higher probability of ABO hemolysis than those with blood type B. This study suggests that serum bilirubin, Hb, and Ret% detection combined with immunohematological tests can improve the detection rate of ABO-HDN.
Abstract:
This study aims to retrospectively analyze the efficacy of penciclovir in the prevention of viral infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Ninety-six patients with allo-HSCT were enrolled, who were treated at the Medical Center of Hematology of Xinqiao Hospital from June 2020 to September 2021. The experimental and control groups were treated with penciclovir and acyclovir, respectively, to prevent viral infection. By February 2022, the infection rates of cytomegalovirus, BK virus, JC virus, and Epstein-Barr virus (EBV) in the experimental group and the control group were 18.8% and 39.06% (P<0.05), 28.1% and 25% (P>0.05), 6.2% and 7.81% (P>0.05), 21.8% and 23.43% (P>0.05), respectively. The infection-related urinary system symptoms of the experimental group and the control group occurred in 4 and 9 patients, respectively, of which 3 and 9 patients died, respectively. Penciclovir can significantly reduce the cytomegalovirus infection rate after allo-HSCT and has better preventive effects than acyclovir without obvious side effects. The effectiveness and safety of penciclovir will be further verified in the future.
Brief Report
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Abstract:
Incompatibility of blood groups or unexpected antibodies are primary considerations when acute hemolysis occurs during or after transfusion. However, less attention is paid to drug-induced immune hemolytic anemia (DIIHA), which is a rare but potentially life-threatening autoimmune disease. We present the case of a 34-year-old woman (group A, RhD+) who was treated with multiple antibiotics after meningioma resection. As her hemoglobin (Hb) decreased significantly from 109 g/L to 52 g/L without obvious bleeding, a blood transfusion was conducted soon after the medication, during which acute hemolysis occurred. An unexpected antibody, anti-M (MNS blood group system), was identified in the patient. It was confirmed that both the recipient and donor were group A, M antigen negative (M−) with CCDee phenotype, and no agglutination reactivity was observed in major crossmatch by testing the specimens before and after transfusion. Meanwhile, the results of the direct antiglobulin test (DAT) changed from negative to positive. Anti-meropenem, a drug-dependent antibody of meropenem, was detected, and hemolysis resolved after cessation. Anti-meropenem may mainly act through an "immune complex-type" reaction that induces intravascular hemolysis. Notably, the peculiarity of this case was dependent on the occurrence time of the acute hemolysis. Hence, it is necessary to raise awareness of DIIHA in clinical antibiotic treatments.
Abstract:
While it is known that the inflammatory state of the recipient may regulate the production of blood group antibodies, the cellular and molecular mechanisms are unclear. Mesenchymal stromal cells (MSCs) can produce inflammatory factors in response to inflammation and regulate inflammatory immunity. To explore how inflammatory MSCs exert influence on blood group antigen-antibody responses, the inflammatory MSC culture solution was added to the blood group antigen-antibody response system. Flow cytometry was used to detect the effect of different concentrations of inflammatory MSC supernatant on the production of blood group antibodies. Western blotting was used to determine whether the IL-1β receptor was expressed on the surface of red blood cells (RBCs). The intensity of antigen-antibody response was detected by serological methods. The results demonstrated that IL-1β produced by inflammation-induced MSCs could directly bind to the surface of erythrocytes and interfere with blood group antigen-antibody responses. This study suggests that inflammatory MSC-derived IL-1β might enhance the strength of blood antigen-antibody responses.
Case Report
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Abstract:
Drug-induced immune hemolytic anemia (DIIHA) is considered a rare condition. Nonsteroidal anti-inflammatory drugs and antineoplastic drugs are the main causes of DIIHA. An 86-year-old male patient with pulmonary infection was admitted to the 960th Hospital of the PLA Joint Logistics Support Force. The patient was treated with ceftazidime in addition to supportive treatment. A history of antibiotics intake and clinical and laboratory hemolysis features were considered to be key bases for DIIHA diagnosis. Clinicians need to be aware of and accurately diagnose this rare complication caused by commonly prescribed drugs to stop the use of causative drugs in time, and therefore, to prevent serious and sometimes fatal consequences.
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Long-term efficacy of haploidentical hematopoietic stem cell transplantation in the treatment of pediatric acute leukemia
Jiali Li, Ting Chen, Xixi Xiang, Peiyan Kong, Jun Rao, Xiaoqi Wang, Lei Gao, Cheng Zhang, Xi Zhang, Li Gao
 doi: 10.46701/BG.2023022022039
Abstract(79) HTML Full Text(36) PDF (384KB)(3)
Abstract:
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the optimal treatment for pediatric patients with high-risk or intermediate-acute myeloid leukemia. Immunotherapies, such as CAR-T cellular therapy, have been rapidly developed, especially for refractory acute lymphoblastic leukemia. However, they are relatively expensive, limiting their widespread use. For patients lacking matched sibling donors, haploidentical donors are an option. This study analyzed the clinical outcomes of 119 pediatric acute leukemia patients who underwent haploidentical HSCT (n=68) or human leukocyte antigen (HLA)-matched HSCT (n=51). The 2-year overall survival (OS) and leukemia-free survival (LFS) in the haploidentical HSCT group were similar to those in the HLA-matched HSCT group (77.6% vs. 88.6%, P=0.076; 55.6% vs. 52.9%, P=0.497). The 3-year probability of total chronic graft-versus-host disease (GVHD) was 21.4% and 34.1% in the haploidentical and HLA-matched HSCT groups, respectively (P=0.526). Analysis of the 3-year cumulative recurrence rate suggested no significant difference between the haploidentical HSCT group and HLA-matched HSCT group (cumulative incidence, 32.7% vs. 31.2%, P=0.801). The cumulative incidence of acute GVHD, non-relapse mortality (NRM), and graft-versus-host relapse-free survival (GRFS) were similar in both groups. There was no difference in transplantation-related toxicity (TRT) in terms of infection, hepatic dysfunction, oral mucositis, and engraftment syndrome between the haploidentical HSCT and HLA-matched HSCT groups. The study suggests that haploidentical HSCT shows comparable OS, LFS, and GRFS to HLA-matched HSCT in pediatric patients with acceptable complications, and can therefore be recommended as an effective alternative for this population.
Efficacy of E-COD regimen in the treatment of HHV-8 negative multicentric Castleman disease
Xiaoyu Liu, Huihan Wang
 doi: 10.46701/BG.2023022022037
Abstract(162) HTML Full Text(77) PDF (215KB)(2)
Abstract:
Castleman disease (CD) is a rare and heterogeneous disease whose treatment options and prognosis vary with clinical types. Multicentric Castleman disease (MCD) is characterized by poor prognosis, and effective treatment options are still being explored. This study aimed to determine whether the E-COD (E: etoposide 50 mg/m2/d, d1–3; C: phosphoramide 750 mg/m2, d1, d3; O: vincristine 2 mg, d1; D: dexamethasone 10 mg/d, d1–5) regimen is effective in treating human herpesvirus-8 (HHV-8)-negative MCD. A group of patients diagnosed with MCD at Shengjing Hospital of China Medical University were treated with E-COD regimen. The effectiveness evaluation was conducted after four treatment cycles and follow-up for survival. A total of 101 patients were included in this study from January 2003 to December 2021, of whom 29 patients had HHV-8 negative MCD subtype. Seven HHV-8 negative MCD patients received four courses of E-COD chemotherapy. The complete response, partial response, and stable disease were 14.3%, 71.4%, and 14.3%, respectively. The follow-up ended on June 1, 2021. Two patients died, and five patients survived, with a survival period ranging from 2 to 11 years. This study suggests that the E-COD regimen is a safe, efficient, and affordable therapy option for HHV-8 negative MCD patients.
Significance of alanine aminotransferase testing in blood donor screening in Chongqing, China: a 7-year retrospective analysis
Min Song, Zhenrui Xue, Yahan Fan, Ziyi Xia, Chenxi Liu, Linxiao Yan, Chunyan Yao
 doi: 10.46701/BG.2023022023016
Abstract(44) HTML Full Text(21) PDF (329KB)(1)
Abstract:
Since 1993, alanine aminotransferase (ALT) testing has been mandatory for blood donor screening in China. This study aimed to evaluate the significance of ALT testing for transfusion safety. Between January 2012 and December 2018, 122236 blood donor samples were routinely screened by the enzyme-linked immunosorbent assay method for transfusion-transmitted disease markers (TTDM) and by the kinetics method for ALT. Out of 2705 (2.21%) seropositive donors, 291 (10.76%) tested positive for ALT alone and were categorized as ALT-only positive donors. Fourteen ALT-only positive donors who all tested negative in subsequent TTDM and nucleic acid testing (NAT) screening were followed up. The return rate for ALT-only positive donors was reduced by 4.1 times as compared with qualified blood donors (P<0.000). The results suggest that ALT testing does not make a significant contribution to reducing the risk of transfusion-transmitted diseases. Furthermore, being disqualified even once owing to elevated ALT levels has a significant impact on donors' return behavior. Therefore, a suitable cutoff value for ALT testing should be considered based on the evaluated risk in both blood safety and supply.