Background: Duffy antibodies play a significant role in hemolytic transfusion reactions and hemolytic disease of the fetus and newborn, Duffy(FY) blood group genotyping an essential part of transfusion medicine. The purpose of this study was to assess the importance of Duffy (FY) DNA typing in conducting transfusion compatibility testing and improving Red Blood Cell matching during transfusion.

Materials and Methods: In this study, 135 blood samples from SCD patients from the Southwest of Iran were included. All samples were tested with Anti-Fya and Anti-Fyb using the hemagglutination technique, and 64 samples with the fy(a+b-) and fy(a-b-) phenotypes were genotyped using DNA sequencing methods.

Results: The prevalence of alloimmunization in this population was 13.04%. fy(a-b+) was the most common phenotype (37/135, 27.4%), followed by fy(a+b-) (35/135, 26%), fy(a+b+) (34/135, 25.2%); and fy(a-b-) (29/135, 21.4%). Among the 64 fy(a+b-) and fy(a-b-) samples, 40 (62.5%) patients had FY*BES allele. 21 out of 40 samples were FY*BES/FY*BES, 17 were FY*A/FY*BES, and 2 were FY*B/FY*BES.

Conclusions: The prevalence of GATA-1 mutation (FY*BES allele), in fy(a-b-) and fy(a+b-) patients was reported 62.5%. Therefore, it is possible to use the genotypic information as a database to facilitate the process of searching and supplying better-matched blood transfusion.

Background: Immune checkpoint inhibitors have significantly improved outcomes in select cancers; however, not all patients respond to these therapies, and the duration of the response varies among responders. Markers predictive of the response to immunotherapy, such as PD-L1 expression determined by immunohistochemical staining of tumor sections and microsatellite status, have been identified. Some of these are used in companion diagnostics approved for clinical practice. Additional easy-to-use biomarkers may help clinicians to predict the efficacy of these drugs in individual patients.

Materials and Methods: A retrospective review of the medical records of patients with metastatic cancer treated with immune checkpoint inhibitors in our cancer center was performed to identify the clinical and hematologic parameters associated with survival outcomes.

Results: Among the 163 patients included in the study, most had lung cancer, followed by kidney cancer, melanoma, and bladder cancer. Most patients (61.3%) were male and had good performance status. Nivolumab and pembrolizumab were immune checkpoint inhibitors utilized in 85.9% of cases. Age, sex, and primary cancer type were not associated with survival outcomes. Among the peripheral blood parameters evaluated, lymphocytopenia was the strongest predictor of adverse survival outcomes in univariate analysis and the only clinical or hematologic biomarker that retained significance for overall survival (OS) prediction in multivariate analysis.

Conclusion: Among the clinical and hematologic parameters routinely used in the clinic, a lymphocyte count below 1 x 10⁹/ L was predictive of adverse OS in patients with metastatic cancers receiving immune checkpoint inhibitors.

Background: Glioblastoma is a prevalent and challenging malignant brain tumor. Secretome therapy using human umbilical cord mesenchymal stem cells (hUCMSCs) appears to be a promising treatment for glioblastoma. This study analyzed the potential of the hUCMSC secretomes (hUCMSCs-sec) for glioma therapy.

Materials and Methods: Characterization of hUCMSCs was performed by examining certain markers, including CD44, CD90, CD105, CD73, CD13, CD19, CD14, CD45, CD34, and HLA-D. The cells' ability to differentiate into adipocytes, chondrocytes, and osteocytes was evaluated. Cytotoxic effect on Glioblastoma (GBM) cells was analyzed using 2-[2-methoxy-4-nitrophenyl]-3-[4-nitrophenyl]-5-[2,4-disulfophenyl]-2H-tetrazolium (WST-8). mRNA relative expression, including homeobox (HOXA5, HOXB1, HOXC9 and HOXC10), insulin-like growth factor binding protein 2 (IGFBP2), Extracellular signal-regulated kinases (ERK), Epidermal growth factor receptor (EGFR), and Caspase 3 (Casp3), were quantified by quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR).

Results: The hUCMSCs-sec was successfully isolated and identified, showing positive markers and its capacity to differentiate into chondrocytes, adipocytes, and osteocytes. hUCMSCs-sec exerted a cytotoxic effect on GBM cells and upregulated the expression of Casp3, whereas it decreased the expression of HOX, IGFBP2, EGFR, and ERK in GBM cells.

Conclusion: The secretomes from hUCMSCs show potential for GBM cell therapy by improving the deregulation of HOX, inducing apoptosis, and inhibiting cell proliferation genes.

Background: Acute lymphoblastic leukemia affects both adults and children. Mixed phenotype acute leukemia (MPAL) is a rare subset featuring blasts with multiple lineage-specific antigens. Diagnosis is made via flow cytometric immunophenotyping with specific CD markers. This study aims to correlate MPAL's incidence, hematological findings, clinical profiles, and immunophenotypic features with treatment outcomes and prognostic significance.

Materials and Methods:  A total of 750 cases of acute leukemia involving pediatric and adult patients were examined at SCB Medical College and Hospital in Cuttack, Odisha. Based on the WHO 2008 criteria, twenty-nine cases of MPAL were identified using morphological, cytochemical, and immunophenotypic features. The study covered all age groups admitted to the Department of Hematology from September 2011 to April 2021.

Results: Flow cytometric analysis of 750 cases showed B lymphoblastic leukemia as the most common subtype. Of the 29 MPAL cases (3.86%), 15 were B/myeloid, 13 T/myeloid, and one B/T/myeloid. Twenty-three cases received induction chemotherapy, with 12 achieving complete remission. The median survival was 11months, with a 15-month survival rate of 39%. Pediatric patients had a 60% survival rate at 15 months, compared to 30% for adults. 

Conclusion:  MPAL is a rare acute leukemia diagnosed through flow cytometry. Prognostic factors include age at onset, CD34 negativity, HLA-DR presence, BCR-ABL fusion, and MLL rearrangement, which indicate a poor prognosis. Children tend to have better outcomes and complete remission than adults, with therapies for ALL being more effective than those for acute myeloblastic leukemia.

Background: Minimal Residual Disease (MRD) assessment is crucial for directing treatment decisions in Acute Lymphoblastic Leukemia (ALL). In low- and middle-income countries, limited resources can present challenges to implementing MRD-guided therapy intensification for ALL. The study attempted to assess the relationship between MRD and other prognostic factors in ALL, focusing on treatment outcomes and disease progression.

Materials and Methods: A retrospective observational study was conducted at Ramaiah Medical College and Hospital in Bengaluru, examining patient data from January 2021 to December 2021. MRD status was determined post-induction using flow cytometry. Patients were classified into various groups based on factors such as type of ALL (B-cell or T-cell), NCI risk status (standard or high), cytogenetic risk (favorable, poor, or intermediate), CNS status, prednisone response, and MRD levels at the end of induction.

Results: Out of 72 patients, 25% were MRD-positive, with a male: female ratio of 2.13:1. B-ALL was diagnosed in 49 patients and T-ALL in 23, with 75% categorized as high-risk by NCI criteria. Cytogenetic analysis revealed a diverse profile (23.61% PR, 48.61% IR, 27.78% FR), and 58.33% exhibited a good prednisone response (GPR). At the end of the induction phase, 25% tested positive for MRD, with B-ALL showing a lower MRD rate at 15.2%. Age and NCI risk status significantly influenced MRD outcomes, with 75% of participants classified as high-risk.

Conclusion: This study demonstrates a significant association between MRD positivity and factors such as age, NCI risk status, and B-ALL diagnosis, underscoring the complex interaction of these variables in predicting treatment outcomes for ALL patients.

Background: Angiogenesis is essential for the survival of neoplasms. Our aim was to describe the clinical profile of primary central nervous system lymphoma (PCNSL) patients at our institution and explore the immunohistochemical expression of OCT4 and nestin in the tumor microenvironment, especially in relation to angiogenesis. 

Materials and Methods: All cases of PCNSL from 2016 to 2022 were retrospectively studied, and clinical and radiological characteristics of the patients were obtained. Descriptive statistics were used.

Results: 26 cases were studied; 24 cases (92.3%) were B-cell lymphomas: 23 diffuse large B-cell, and one Burkitt lymphoma. 7.7 % were of T lineage. 13 women and 13 men, had age ranges between 33-71 years (mean 58.16 years). Three patients (12 %) had immunosuppression. Nestin staining revealed hypertrophic astrocytes forming patches about blood vessels with positive cytoplasmic staining in endothelium and pericytes (5-10% of the intra-tumor arterioles). These findings were seen in both B and T lymphomas. OCT4 nuclear expression was only observed in five large B-cell lymphomas and seemed to have a relationship with mitoses/HPF (high power field).

Conclusion: The novel finding of endothelial, pericytes and hypertrophic astrocytes staining with nestin, points to the involvement of stem cells promoting angiogenesis as a result of a dialogue between neoplastic cells and vascular stem cells. OCT4 expression seems to have a relationship with cell proliferation whose clinical significance should be investigated in prospective studies.

RET-He is a cost-effective parameter to assess iron status in CKD, but further research is necessary to assess its correlation with existing parameters. This study attempted to investigate the correlation between RET-He, iron status, and erythrocyte indices among CKD patients.

Materials and Methods: A cross-sectional study involving 110 CKD patients who underwent routine hematology and iron profile tests (serum iron/SI, total iron binding capacity/TIBC, transferrin saturation/TSAT, and ferritin). RET-He was then measured using a Sysmex XN-1000 hematology analyzer. Statistical tests were used to define the correlation between RET-He), iron status, and erythrocyte indices.

Results: There was a significant positive correlation between RET-He and SI (r = 0.349; p = 0.000), TSAT (r = 0.393; p = 0.000), and ferritin (r = 0.279; p = 0.003). Among CKD patients with excess iron levels, there was a moderate correlation between RET-He and TSAT (r = 0.404; p = 0.000).

Conclusion: The study found a significant correlation between RET-He levels and iron status markers in CKD patients. RET-He is recommended as an additional parameter to assess iron status and as an additional method to estimate TSAT and ferritin levels, especially in settings where chemistry analyzers are unavailable. Further research is required to establish RET-He cut-off values for identifying excessive iron levels in CKD patients.

for acute leukemia, though outcomes in older patients remain suboptimal due to higher non-relapse mortality (NRM) and relapse rates. Innovations in conditioning regimens and supportive care have made HSCT accessible to patients over 50, but age-related disparities in outcomes persist.

Materials and Methods: This 10-year retrospective cohort study reviewed all patients who underwent first-time allogeneic HSCT for acute leukemia. Patients were stratified by age at HSCT (≥ 50 years and < 50 years), and outcomes were assessed for overall survival (OS), disease-free survival (DFS), NRM, and relapse incidence (RI).

Results: Of the 1199 patients, 152 were 50 years or older. Five-year OS rates were markedly lower in patients ≥ 50 years compared to younger patients (48.70% vs. 59.35%; P= 0.024 for AML and 23.60% vs. 41.96%; P= 0.025 for ALL). Moreover, older patients demonstrated significantly higher NRM rates (35.95% vs. 23.53%; P= 0.045 for AML and 78.14% vs. 26.76%; P= 0.005 for ALL) and a notably increased incidence of grade III-IV acute graft-versus-host disease (aGVHD). Interestingly, no significant differences were observed between the two age groups regarding DFS rates and RI.

Conclusion: Older acute leukemia patients undergoing allogeneic HSCT face significant challenges, including elevated NRM and GVHD rates. While relapse rates were comparable, survival outcomes favored the younger cohort. These findings emphasize the need for age-adapted transplantation strategies, using reduced-intensity conditioning (RIC) regimens and further research to refine risk stratification and improve management approaches for older patients.

Hematopoietic stem cell transplantation (HSCT) is considered a potentially curative treatment for several malignant and non-malignant hematologic disorders including transfusion-dependent thalassemia (TDT). However, HSCT is associated with short-term and long-term complications. One of the recognized causes of morbidity and mortality in TDT patients is heart-related complications. Additionally, cardiac involvement is likely to be more common in patients who proceed to HSCT. So the risks of cardiac complications should be carefully weighed against the advantages of the primary disease cure. This review aims to discuss the cardiac considerations that should be kept in mind in TDT patients going through the path of HSCT.

Thrombotic thrombocytopenic purpura (TTP) is a medical condition characterized by a decreased activity of the ADAMTS13 protease,  responsible for cleaving the von Willebrand factor. It contributes to thrombotic microangiopathy. In this report, we described a case of TTP  followed by significant adverse effects during therapeutic plasma exchange (TPE) treatment. The patient received TPE with a time interval from plasma transfusion.

A 30-year-old female was evaluated for headaches and bruises on her arms and legs. Laboratory testing revealed thrombocytopenia and anemia. The identification of thrombocytopenia with severe schistocytosis was verified by the analysis of a peripheral blood smear. After confirming a diagnosis of TTP, TPE was performed as therapy. To avoid the complications arising during the previous TPE sessions, we conducted plasma exchange with albumin followed by FFP injection, with a six-hour interval between them. This strategy successfully alleviated the patient's symptoms.

Therapeutic plasma exchange (TPE) with a time interval from plasma transfusion can be successfully used in patients with severe TPE complications.

Blastic plasmacytoid dendritic cell neoplasms (BPDCN) are rare, aggressive hematologic neoplasms. Awareness about this neoplasm has increased after it was defined as a clonal plasmacytoid dendritic cell disease under histiocytic/dendritic cell neoplasms in the World Health Organization 2022 classification of myeloid and Histiocytic/Dendritic Neoplasms¹. Therapies include chemotherapy or immunotherapy^2-4 though stem cell transplantation (SCT) is the best consolidative approach in eligible patients⁵. Here, we present one intensive therapy-ineligible and two intensive-therapy-eligible patients with different presentations of BPDCN.

Individually customized grafts have become standard for reconstructing extensive chest wall defects resulting from surgical interventions for sternal malignant neoplasms. However, the outcomes of these graft implantations can be further improved by administering patient-derived cells, which have minimal oncological risks. In 2021, a 52-year-old woman with chondrosarcoma (pT2N0M0G2, stage IIB) was admitted to the Department of Thoracic Surgery. The patient presented with a large tumor in the body of the sternum, measuring 81 × 94 × 91 mm, according to the computed tomography (CT) scan. To address this, an individualized endoprosthesis was modeled and created using the original 'pincer-dock' construction based on CT-scan screens. The mononuclear cell fraction (MNCs) was obtained from the patient's peripheral blood one week before surgery using a Haemonetics cell separation device and cryopreserved until the day of the procedure. The resulting 30 mL MNC suspension contained 12 mln cells per 1 mL. We performed flow cytometry analysis using a FACS Aria III flow cytometer to confirm the presence of mesenchymal stromal cells in the MNCs. We also performed immunostaining for S-100, a common tumor marker for benign and malignant diseases, and D2-40, a marker for the lymphatic endothelium that reacts with Kaposi's sarcoma and a subset of angiosarcomas. None of the cells were positive for either marker. Approximately 3 ml of the MNC suspension was injected into each rib edge and 30 ml into the operating field immediately after resection. The titanium endoprosthesis was placed in the sternal defect, and the body of the endoprosthesis was securely covered with a laparoscopically mobilized omental flap. After a one-year follow-up, the patient showed no signs of recurrence or post-surgical complications. These outstanding functional and cosmetic results highlight the potential for the broader clinical utilization of minimally manipulated cells in personalized medicine in oncology. These results could pave the way for wider clinical application of peripheral blood-derived minimally manipulated cells in personalized medicine as an adjuvant for titanium endoprosthesis reconstruction of osteochondral defects in patients with sarcoma.