IntroductionDuring the coronavirus disease 2019 (COVID-19) pandemic, vitamin D has been established as an immune-modulator that reduces pro-inflammatory damage which effectively diminish the severity of COVID-19. Vitamin D also has a significant effect against influenza and dengue and increase the seroconversion following influenza vaccination. To date, the role of vitamin D in optimizing the efficacy of COVID-19 vaccines remains unclear. This study aimed to analyze the correlation between serum 25-hydroxy-cholecalciferol or 25(OH)D levels and anti-SARS-CoV-2 S-RBD IgG and neutralizing antibody levels among cancer patients.MethodologyA multicenter cross-sectional study was conducted among solid and hematologic cancer patients who were vaccinated with two doses of the same types of COVID-19 vaccines (either mRNA, non-replicating viral vector, or inactivated) within 6 months.ResultThe median serum 25(OH)D level in 119 cancer patients was 36.36 [IQR = 30.30] ng/mL. The seropositivity of S-RBD IgG and NAb reached 93.3 and 94.1%, respectively. The S-RBD IgG level was significantly higher in the sufficient group (median = 414.07 [1,441.83] AU/mL) than in the deficient group (median = 91.56 [652.00] AU/mL) (p-value = 0.049). Among non-chemotherapy subjects, the anti-SARS-CoV-2 S-RBD IgG levels had a significant positive correlation with 25(OH)D levels (p-value = 0.03; R = 0.588). The NAb levels also showed significantly positive correlation with 25(OH)D level (p-value = 0.005; R = 0.561). The 25(OH)D levels were positively correlated with S-RBD IgG levels among subjects younger than 60 years old (p-value = 0.047; R = 0.136). However, serum 25 (OH)D levels showed no such correlation with S-RBD IgG levels among subjects older than 60 years old (p-value = 0.933; R = 0.136).ConclusionBoth anti-SARS-CoV-2 S-RBD IgG and NAb levels developed moderate correlation with 25(OH)D levels among subjects treated without chemotherapy. The S-RBD IgG levels also had positive correlation with 25(OH)D levels among subjects younger than 60 years old. Thus, we recommended cancer patients to maintain serum 25(OH)D levels above 30 ng/mL (75 nmol/L) to enhance the efficacy of COVID-19 vaccines.

Pengetahuan mengenai manfaat klinis kadar magnesium serum baru dimulai akhir-akhir ini seiring dengan adanya analisis dan penemuan bahwa kadar magnesium abnormal pada gangguan kardiovaskuler, metabolik dan neuromuskuler. Meskipun kadarnya di serum tidak menggambarkan kadar magnesium tubuh, tetapi saat ini yang dikenal luas penggunaannya hanya pemeriksaan kadar magnesium serum. Magnesium eritrosit saat ini dinilai lebih sensitif dari pada magnesium serum, karena magnesium eritrosit dapat mewakili penilaian status magnesium intrasel. Menurut NCCLS (National Committee for Clinical Laboratory Standards) setiap laboratorium dianjurkan memiliki nilai rujukan sendiri untuk pemeriksaan yang dikerjakannya, termasuk juga pemeriksaan magnesium. Nilai rujukan yang didapat sesuai dengan populasi dan dipengaruhi oleh metode serta teknik pemeriksaan. Penelitian ini bertujuan untuk mendapatkan nilai rujukan magnesium dalam serum dan plasma serta mendapatkan nilai rujukan magnesium intrasel yaitu magnesium eritrosit dengan metode pemeriksaan langsung dan mengetahui perbandingan hasil pemeriksaan antara magnesium serum dengan plasma. Bahan darah diambil dari 114 peserta donor darah di Unit Transfusi Darah Daerah (UTDD) Budhyarto PMI DKI Jakarta, terdiri dari 57 orang pria dan 57 orang wanita berusia antara 17-65 tahun, secara klinis sehat menurut kriteria donor darah PMI. Darah diambil dari selang blood set, langsung dimasukkan 4 mL ke dalam tabung vakum tanpa antikoagulan untuk pemeriksaan magnesium serum dan 3 mL kedalam tabung vakum dengan antikoagulan lithium heparin untuk pemeriksaan magnesium eritrosit dan plasma. Penetapan kadar magnesium dilakukan dengan alat kimia klinis otomatis Hitachi 912 dengan metode Xylidil Blue dengan prinsip kolorimetri.Pada penelitian ini didapatkan tidak ada perbedaan bermakna untuk hasil pemeriksaan magnesium ekstrasel memakai bahan serum maupun plasma heparin. Nilai rujukan untuk magnesium serum atau plasma adalah 1.30-2.00 mEq/L dan magnesium eritrosit adalah 4.46-7.10 mEq/L.

Background Cancer patients have an increased risk of a severe COVID-19 infection with higher mortality rate. This study aimed to analyze the levels of anti-SARS-CoV-2 S-RBD IgG and NAB among cancer patients who were vaccinated with COVID-19 vaccines, either with BNT162b2, mRNA-1273, AZD1222/ChAdOx1nCoV-19, or Coronavac/BBIBP-CorV vaccines. Method A cross-sectional study was conducted among subjects with either solid or hematological cancers who had received two doses of either mRNA or non-mRNA vaccines within 6 months. The levels of anti-SARS-CoV-2 S-RBD IgG and NAb were analyzed using the Mindray Immunoassay Analyzer CL-900i. Statistical analysis was conducted using mean comparison and regression analysis. Result The mRNA-1273 vaccine had the highest median levels of S-RBD IgG and NAb, followed by BNT162b, ChAdOx1nCoV-19, and BBIBP-CorV/Coronavac. The levels of S-RBD IgG and NAb in subjects vaccinated with mRNA vaccines were significantly higher than those of non-mRNA vaccines when grouped based on their characteristics, including age, type of cancer, chemotherapy regimen, and comorbidity (p<0.05). Furthermore, the S-RBD IgG and NAb levels between the subjects vaccinated with non-mRNA vaccines and the subjects vaccinated with mRNA vaccines were significantly different (p<0.05). However, there was no significant difference between the same types of vaccines. This study demonstrated a very strong correlation between the level of S-RBD IgG and the level of NAb (R = 0.962; p<0.001). The level of anti-SARS-CoV-2 S-RBD IgG was consistently higher compared to the level of NAb. Conclusions Generally, mRNA vaccines produced significantly higher anti-SARS-CoV-2 S-RBD IgG and NAb levels than non-mRNA vaccines in cancer subjects.

Background: Cytopenia is the primary phenomenon in myelodysplastic syndrome (MDS) amidst hypercellular bone marrow. The soluble CD40 ligand (sCD40L) is considered as a cytokine that can trigger synthesis of tumor necrosis factor α (TNFα) that promotes apoptosis. The objective of this study is to prove that recombinant human sCD40L (rh-sCD40L) exposure on bone marrow mononuclear cells (BMMC) MDS increases TNFα expression at mRNA level and at protein level.Methods: BMMC from MDS patients whom diagnosed and classified using the WHO 2008 criteria, were exposed to rh-sCD40L and antiCD40L. The expressions of TNFα mRNAs were quantified by qRT-PCR, level of TNFα were measured using the ELISA method.Results: Exposure of rh-sCD40L significantly increased the expression of TNFα mRNA. The similar exposure also significantly increased the level of TNFα compared to controls. TNFα mRNA expression on BMMC in MDS samples exposed to rh-sCD40L is 3.32 times compared to TNFα mRNA expression without exposure. level of TNFα in supernatant media exposed to rh-sCD40L in MDS samples was higher than that of control samples which were 44.44 and 4.85 pg/mL, P=0.018. Conclusions:The sCD40L plays a role in increasing the synthesis of TNFα in mRNA level and protein level in BMMC MDS.

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Iron in plasma is carried by transferrin delivered to cells through the interaction with a specific membrane receptor, namely transferrin receptor. The soluble transferrin receptor (sTfR) is a transferrin receptor monomer which lost its first 100 amino acids, and circulates in the form of transferrin and its receptor complex. Erythroblasts and reticulocytes are the main source of serum TfR The concentration of sTfR in serum is useful to diagnose iron deficiency, especially for patient with chronic disease. A new parameter sTfR is reported to be a surrogate marker of bone marrow iron store. The sTfR concentration can describe the functional iron status while ferritin reflects the iron storage status. The aim of this study was to know a reference interval of sTfR in normal adults by provision. Subjects were 157 healthy adults from clinical medical check up who had met the inclusion criteria and were willing to participate as research subjects. Soluble Transferrin Receptor (sTfR) examination was performed using reagents from Roche. The statistical calculations were performed by SPSS 22. The results showed that there was no significant difference between sTfR levels in men and women as well as in the age group ≤40 years and >40 years. The STfR reference value in this study was calculated based on 95% CI (X±2SD), is 0.197–0.598 mg/dL. It can be concluded that the sTfR reference value is 0.197–0.598 mg/dL

<b>Background</b>: In the era of coronavirus disease 2019 (COVID-19), it is mandatory to identify vulnerable people with cancers as they have impaired immune system that can lead to high mortality. This study analyzes the complete blood count (CBC) derived inflammatory biomarkers and the level of anti-SARS-CoV-2 neutralizing antibody (NAb) and spike protein’s receptor-binding domain immunoglobulin G (S-RBD IgG) among cancer survivors.<br /> <b>Methods</b>: A cross-sectional study was conducted in patients with either solid or hematological cancers who had received two-doses of COVID-19 vaccinations within six months.<br /> <b>Results</b>: From 119 subjects, the COVID-19 vaccines demonstrated laboratory efficacy (median NAb=129.03 AU/mL; median S-RBD IgG=270.53 AU/mL). The seropositive conversion of NAb reached 94.1% and S-RBD IgG reached 93.3%. Additionally, the S-RBD IgG had very weak correlation with absolute monocyte count (R=-0.185; <i>p</i>-value=0.044). The NAb also had very weak correlation with leukocyte (Kendall’s tau-b (τb)=-0.147; <i>p</i>-value=0.019), absolute neutrophil count (τb=-0.126; <i>p</i>-value=0.044), absolute eosinophil count (τb=-0.132; <i>p</i>-value=0.034).<br /> <b>Conclusion</b>: The seropositivity rate of anti-SARS-CoV-2 NAb and S-RBD IgG were significantly high. However, the CBC derived inflammatory biomarkers had poor correlation with anti-SARS-CoV-2 NAb and S-RBD IgG. Thus, anti-SARS-CoV-2 NAb and S-RBD IgG are currently the only reliable markers for measuring the COVID-19 vaccine efficacy which should be widely accessible.

Iron in plasma is carried by transferrin delivered to cells through the interaction with a specific membrane receptor, namelytransferrin receptor. The soluble transferrin receptor (sTfR) is a transferrin receptor monomer which lost its first 100 amino acids, andcirculates in the form of transferrin and its receptor complex. Erythroblasts and reticulocytes are the main source of serum TfR Theconcentration of sTfR in serum is useful to diagnose iron deficiency, especially for patient with chronic disease. A new parameter sTfRis reported to be a surrogate marker of bone marrow iron store. The sTfR concentration can describe the functional iron status whileferritin reflects the iron storage status. The aim of this study was to know a reference interval of sTfR in normal adults by provision.Subjects were 157 healthy adults from clinical medical check up who had met the inclusion criteria and were willing to participate asresearch subjects. Soluble Transferrin Receptor (sTfR) examination was performed using reagents from Roche. The statistical calculationswere performed by SPSS 22. The results showed that there was no significant difference between sTfR levels in men and women as wellas in the age group ≤40 years and >40 years. The STfR reference value in this study was calculated based on 95% CI (X±2SD), is0.197–0.598 mg/dL. It can be concluded that the sTfR reference value is 0.197–0.598 mg/dL.