No abstract

Minimal residual disease (MRD) describes disease that can be diagnosed by methodologies other than conventional morphology, and includes molecular methods (like polymerase chain reaction (PCR)) or flow cytometry (FCM). Detection and monitoring of MRD is becoming the standard of care, considering its importance in predicting the treatment outcome. MRD aids in identifying high-risk patients and hence therapy can be intensified in them while deintensification of therapy can prevent long-term sequelae of chemotherapy in low-risk category. FCM is considered as a less labor-intensive and faster MRD technique as compared to PCR although it has its own share of disadvantages. Current immune-based methodologies for detection of MRD depend on establishing leukemia-associated aberrant immunophenotype (LAIP), at diagnosis or relapse and use this information at specified time points for detection of MRD, or apply a standardized panel of antibody combinations for all MRD cases, in a different-from-normal approach. This review highlights MRD detection by FCM and its application in acute leukemia.

Background:As processing and cryopreservation of cord blood is time consuming and costly, it is essential to select units with optimal CD34+ cells, total nucleated cell (TNC) number and colony forming units (CFUs). These are the most important factors affecting outcome of UCB transplantation and are influenced by various maternal and neonatal factors.Aim and objectives:To determine the maternal and neonatal factors affecting TNC and CD34+ cell counts in cord blood so as to aid in proper selection of cord blood units for cryopreservation.Materials and Methods:A total of 100 UCB units were collected from normal vaginal deliveries, processed and assessed for volume, TNC, CD34+ cell count and CFU-GM. These parameters were then analyzed to find out whether they correlated with maternal and neonatal characteristics such as mother's age, parity, gestational age, baby's birth weight, and sex.Results:The volume of CB collected significantly correlated with the TNC, CD34+ cell, and CFU-GM yields (P < 0.02). A heavier placenta (P < 0.05), and a heavier baby (P < 0.002) were associated with a significantly greater volume of CB whereas the age, parity of mother and the sex of the baby had no significant effect.Conclusion:The only factors found to affect the TNC and CD34+ cell counts significantly were weight of the baby and placenta and the volume of cord blood collected. Since these factors are of prognostic significance, their analysis will aid in deciding which UCB unit should be processed and cryopreserved for UCB banking and subsequent transplantation.

Many blood centres in country don't have costly apheresis technology and rely heavily on the platelet production from whole blood donation. We conducted this study with the aim to compare the quality of platelet concentrates (PC) prepared by Buffy Coat derived (BC-PC) and apheresis derived platelet concentrate (Apheresis-PC). Our objective was to collect data by analysis of platelet concentrates prepared by BC-PC methods and Apheresis-PC methods in respect of swirling, volume, platelet count, WBC count and pH of the PC units and elaborate on the quality parameters. Tertiary Care Hospital and Medical College. We assessed a total of 200 BC-PC and 200 Apheresis-PC for their in vitro quality by observing swirling, volume of PC, platelet count/unit, WBC count/unit and pH, to see if they satisfy the recommended quality criteria. Data was analyzed using appropriate statistical technique under the guidance of biostatistician. Apheresis-PC units showed better swirling than BC-PC units (Chi square test; P < 0.05). There was a significant difference in proportion of units satisfying the required volume QC between the two methods (Chi-square test; P < 0.05). Apheresis-PC showed better adherence to the physiological pH values (Student's unpaired t test; P < 0.05). The units of BC-PC and Apheresis-PC did not show significant difference in proportion of units satisfying the Platelet count per unit and residual WBC count per count (Chi square; P 0.203 and 0.617 respectively). There was comparable adherence to QC requirement for platelet count and WBC contamination in two methods. BC-PC were found to be adhering lesser to QC parameters for swirling, volume and pH, but found to be in required QC limits. BCPC can be used effectively in the majority of thrombocytopenic patients in resource poor setting.

After an overall assessment of all our in vitro parameter results and observations, a few of which were significant, while most were not significant, we concluded that a well-preserved quality of gamma irradiated apheresis platelets is maintained throughout the entire 5-day shelf life of the platelet product, with minimal difference compared to non-irradiated platelets.

a b s t r a c tBackground: The Rh system is the major blood group system besides ABO system. Even after proper blood grouping and cross matching there is a possibility of alloimmunization and antibody production in the recipients against the Rh or minor blood group antigens like Results: The phenotypic frequencies of Rh blood groups in the studied population were D-92.25%, C-87.55%, E-26.55%, c-51.06% and e-98.42%. Thus 'e' was the most common and E was the least common of all the Rh types. Phenotypically DCCee group was the most common phenotype and dccee was least common type.Conclusion: Determination of Rh phenotypes can play a major role in preventing alloimmunization and avoiding adverse events in multitransfusion cases.ª 2013, Armed Forces Medical Services (AFMS). All rights reserved.

Knowledge of transfusion medicine (TM) has profound impact on transfusion outcomes. Variations from the standards in practices of TM may jeopardize patient care. We assessed the awareness of TM in resident doctors. Our aims was to assess the essential knowledge of TM among resident doctors. The study was carried in a tertiary care hospital. It was a descriptive cross-sectional study using a self-administered, questionnaire comprising of 35 items which was developed to assess the essential knowledge of TM for resident doctors. A total of 85 residents responded from various clinical specialties. Statistical analysis used: Results of correct response were put as Mean ± SD using SPSS. Survey revealed an overall mean score of 48.53 % for correct responses. Lowest knowledge score of 32.94 % was found for blood bank procedures. The differences between the knowledge of residents from various specialities were not statistically significant. Our study shows that majority of resident doctors have inadequate knowledge of TM. More studies are required from different parts of the country to create data on this issue. The implementation of two weeks training for all residents from clinical specialties in TM department will improve the situation and help to connect our clinician to TM better.

In India transmission of transfusion transmissible infections (TTI) has shown a relative decrease as a result of mandatory screening of donated blood for TTI's. However, reducing the incidence of non infectious complications poses a major challenge, mainly due to the fact that a number of adverse reactions go unreported. Blood transfusion reaction, can be categorized based on the time interval between transfusion of blood products and the presentation of adverse reactions as acute i.e. those presenting during or within 24 h and as delayed i.e. those presenting anytime after 24 h. Transfusion reactions can further be classified as immune and non immune or infectious and non infectious based on the pathophysiology. In this retrospective study which was undertaken with an aim to determine the type and frequency of non infectious complications due to transfusion of blood and blood products recorded the incidence of febrile non hemolytic transfusion reactions (FNHTR) 51.40 %, allergic reactions 40.14 %, non immune hemolytic reactions 4.22 %, hypothermia 2.81 %, anaphylaxis 0.70 % and iron overload 0.70 %. FNHTR which was found to be the most common complication in this study can certainly be minimized, if not completely eliminated by adopting a policy of universal leucodepletion, the implementation of which solely depends on the financial and infrastructure resources available. This study also reiterates the importance of hemovigilance as a tool to improve the safety of blood transfusion.