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Objective: Blood product transfusion is one of the most commonly used medical interventions worldwide. However, transfusion-related adverse events (TRAEs) can cause morbidity and rarely even mortality. For this reason, hemovigilance studies have recently gained importance in terms of safe and effective implementation of transfusion. Material and Method: Transfusion practices issued in the period of 2016-2023 were analyzed retrospectively. All TRAE including adverse reactions (AR) and adverse events (AE) were recorded. The impact of hemovigilance practices on the incidence of TRAE was analyzed by comparing the numbers and types of events between years. Results: In the 8-year period between 2016 and 2023, a total of 135,506 blood products belonging to 45,571 patients were used. 172 adverse reactions (AR) were reported in 170 patients. The overall AR incidence was found to be 126.8 (/100000). The highest yearly AR rate was reported in 2018 with 168.04 (/100000). Since hemovigilance measures were tightened, a statistically significant decrease was recorded in ARs from the beginning of 2020 to date (p<0.001). Conclusion: The result of the current study demonstrated that a reduction in ARs could be achieved with hemovigilance measures. Although some common TRAEs like allergy seem unlikely to prevent due to the underlying pathophysiological mechanisms, we hope that our study showing that some reactions can be reduced by hemovigilance will encourage clinicians and hemovigilance units. Even though hemovigilance studies are being conducted to improve transfusion safety, the most critical concern is reducing exposure to blood components. [ABSTRACT FROM AUTHOR]

Background: Non-hemolytic acute transfusion reactions (ATRs) are generally not fatal, but they can cause serious increases in workload and costs as a result of blood product wastage. Methods: A retrospective analysis was made of the data of the 7-year period between January 2016 and December 2022 to identify the possible associations between patient and product characteristics and the development of ATRs. Results: A total of 113,666 blood products were transfused during the study period. There were 146 ATRs with an estimated rate of 1.28 per 1000 blood products administered. The most common ATR was mild allergic reactions (n = 84, 57.6%). No statistically significant relationship was found in blood group distribution between patients who had and did not develop ATR (p = 0.797). Febrile Non-hemolytic Transfusion Reaction (FNHTR) was more common in patients receiving erythrocyte suspension (ES) transfusion, and Fresh Frozen Plasma (FFP) was mostly used in those with mild allergic reactions (p < 0.001). Patient age was determined as > 60 years in those who developed FNHTR or 'others,' and < 60 years in patients with mild allergic reactions (p = 0.046). Conclusion: The results of the current study demonstrated that regardless of blood group, the probability of developing FNHTR is high when ES is transfused in elderly patients, and the probability of developing mild allergic reaction is high when FFP is used. While recognizing that ATRs are difficult to prevent, it can be emphasized that prediction and management may become easier if clinicians keep these possibilities in mind when making transfusion decisions. [ABSTRACT FROM AUTHOR]

Objectives: The Wilms' tumor gene 1 (WT1) plays a critical role in cell development and the regulation of essential genes involved in cell growth and metabolism. In the context of hematopoietic tumors, including acute myeloid leukemia (AML), WT1 has been identified as a potential marker for measurable residual disease (MRD) assessment. Relapse after allogeneic hematopoietic stem cell transplantation (allo-SCT) remains a significant challenge in AML treatment, highlighting the importance of MRD monitoring for risk stratification and treatment decisions. This study aimed to investigate the clinical significance of WT1 as a molecular marker for MRD and its correlation with chimerism in AML patients post-allo-SCT setting. Methods: We have included 58 patients with WT1-expression-positive acute myeloid leukemia (AML) who received allo-SCT in our center between 2016–2022. The exclusion criteria are as follows: not having WT1 polymerase chain reaction (PCR) measurement at diagnosis, not receiving allo-SCT, and not having a serial measurement of WT1 post-transplant. Pre- and post-transplant assessments were made with flow cytometry, WT1 PCR, and bone marrow morphological evaluations. Statistical analyses were carried out to explore correlations between WT1 levels, MRD markers, and chimerism post-transplantation. Results: We found that WT1 had a significant correlation with flow cytometry and bone marrow morphological evaluation, but not with chimerism. Interestingly, high WT1 expressors exhibited a more robust correlation with chimerism compared to the general cohort. The negative predictive value for post-allo-SCT relapse was 91.8% for the whole WT1 cohort; for high WT1 expressors, it was similar, at 87.5%. The negative predictive value for post-allo-SCT relapse was high for the whole WT1 cohort; for high WT1 expressors, it was similar. The WT1 MRD assay showed a high negative predictive value for post-allo-SCT relapse, consistent across both the entire cohort (91.8%) and high WT1 expressors (87.5%). Conclusions: WT1 expression levels may serve as a valuable ancillary marker in MRD assessment and relapse prediction post-allo-SCT in AML patients, particularly for those lacking specific fusion genes or mutations. However, further large-scale, controlled studies are needed to standardize WT1 MRD assays and establish clear guidelines for their clinical application. [ABSTRACT FROM AUTHOR]

Introduction: Cyclosporine‐A (CsA) and post transplantation cyclophosphamide (PTCy) are common agents used for graft versus host disease (GVHD) prophylaxis in Haploidentical hematopoietic cell transplantation (haplo‐HCT). However, the impact of CsA cessation timing in the posttransplant setting on clinical outcomes is uncertain. We aimed to investigate the impact of a novel approach that integrated early CsA cessation with PTCy utilization. Patients and Methods: This study was a single arm retrospective study carried out at a tertiary referral hospital hematology and bone marrow transplantation center between 2009 and 2022. The patients who received haplo‐HCT with ATG, PTCy and CsA as GVHD prophylaxis were included. CsA was planned for cessation starting at day 45 to day 60. Acute and chronic GVHD were evaluated and graded. CsA blood concentrations and its impact on acute and chronic GVHD was evaluated. Results: Thirty‐one patients composed of 19 (61.3%) male and 12 (38.7%) female patients with a median age of 31 years (20–58). Busulfan and TBI based conditioning regimens were the most utilized regimens. The majority of donors were first degree relatives. Stem cell origin was peripheral blood for all patients. GVHD prophylaxis consisted of ATG, CsA and PTCy. Acute GVHD was observed in 9 (29%) cases, whereas chronic GVHD was seen in 3 (9.7%) cases, with 2 of them having overlapping GVHD. Age, gender, number of chemotherapy lines, transplant characteristics, infused CD34 cell count, and engraftment durations were similar among patients with and without GVHD. Patients with GVHD had similar 1st, 2nd, 3rd and 4th week CsA concentrations compared to patients without GVHD (p > 0.05). The presence of GVHD was not associated with worse progression free survival and overall survival (p = 0.6, p = 0.5, respectively). CMV reactivation was more common in the GVHD group. Conclusion: In the current study, we did not find an impact of CsA concentration on GVHD and post‐transplant outcomes in Haplo‐HCT setting. Therefore, together with the use of PTCy, early CsA cessation can be an option; further studies are needed to understand all aspects of this approach. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of head and neck lymphadenopathy (LAP) and intraoral findings (non‐dental/dental) in patients with newly diagnosed acute leukemia (AL). Subjects and methods: Twenty‐eight (52.8%) females and 25 (47.2%) males in a total of 53 patients with newly diagnosed AL with a mean age of 46 years were included in the study. Personal information, the type of AL (AML [acute myelogenous leukemia]/ALL [acute lymphocytic leukemia]), and hematological findings (anemia, neutropenia, and thrombocytopenia) were obtained from medical records. One of two calibrated oral diagnosis and maxillofacial radiology specialists performed extraoral (head and neck LAPs) and intraoral (non‐dental and dental) clinical examinations. The Chi‐square (χ2) test was used to evaluate categorical variables. Results: LAP was observed in 22.6% and intraoral findings in 30.2% of the patients. LAP was most commonly observed in the neck and none in the parotid glands. The most intraoral findings were gingival/mucosal bleeding and oral petechiae/ecchymosis. While there was no statistical difference between AML and ALL patients in terms of LAP (p >.05), intraoral findings were observed more in patients with AML (p <.05). Only two (3.8%) patients had dental findings. With a slight difference, intraoral findings were more with thrombocytopenia and LAP with neutropenia. Conclusion: In AL, especially non‐dental intraoral findings are common. The fact that dentists working in the oral cavity are often the first specialists to encounter the oral manifestations of AL imposes an important role in early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background Diffuse large B-cell lymphoma (DLBCL), a heterogeneous type of lymphoma, encompasses various biologic abnormalities and numerous morphologic variants, showing several clinical findings and responses to treatments. Lactate dehydrogenase (LDH) is a well-established diagnostic and prognostic marker for DLBCL, and neutrophil/lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and mean platelet volume (MPV) have been shown to have prognostic values in several malignancies. Objectives In the study, we examined the prognostic value of LMR, NLR, LDH, and MPV in the stage and prognosis of DLBCL by analyzing the data of patients treated with rituximab-based chemotherapies. Patients and methods A total of 188 patients diagnosed as having DLBCL between January 2012 and January 2020 were selected. DLBCL stages were categorized as early and late, international prognostic index was categorized as below and above 4, and the treatment response was categorized as responders and nonresponders. NLR, LMR, LDH, MPV, and other factors predicting these outcomes were analyzed. Results Logistic regression analysis showed that the factors influencing stage of DLBCL were NLR [P=0.009, odds ratio (OR)=1.220, 95% confidence interval (CI): 1.050–1.417] and LDH (P=0.001, OR=0.286, 95% CI: 0.146–0.561). The factor influencing international prognostic index score was LMR (P=0.001, OR=6.226, 95% CI: 2.092–18.533). Factors influencing response were R-CHOP treatment (P=0.001, OR=0.181, 95% CI: 0.068–0.478) and stage (P=0.005, OR=18.306, 95% CI: 2.383–140.607). Conclusion The pretreatment LMR, NLR, LDH, and MPV values may affect the stage and prognosis of DLBCL, which showed influences on the treatment response. [ABSTRACT FROM AUTHOR]

Chronic myeloid leukemia (CML) incidence has recently increased in younger individuals. With time, given the nature of the disease and available therapies, as well as the existing paucity and inconsistency of advice, worries about fertility have surfaced. With all these clear unknowns, we designed this study to raise awareness among both physicians and CML patients about whether male and female patients of childbearing age were using contraception at the time of diagnosis, and if so, which methods they were using. In this context, this study aimed to evaluate the contraception methods in patients with CML.Eighteen centres from Turkey participated in the study. Male and female patients of childbearing age diagnosed with chronic and accelerated phase CML between the years 2000 and 2024 were evaluated retrospectively.Of the two hundred and thirty-two patients included, one hundred and twenty-five (53.9%) of these patients were female and 107 (46.1%) were male. At diagnosis, all female patients were in the childbearing age, and male patients were sexually active. The median age at diagnosis of the patients was 38 (range, 18–77) years. Eighty-six (68.8%) female patients were using any contraception method, while this was 53.2% (n = 57) among male patients.In conclusion, since CML patients are diagnosed at an earlier age and the desire of these patients to have children, adequate information and evaluation should be provided regarding fertility and contraception issues, especially in female patients, from the moment of diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Autologous stem cell transplantation (ASCT) is a well-established consolidation treatment for many hematologic cancers which delivers prolonged survival. A subset of patients' adequate stem cell harvest is not achievable with a solitary use of granulocyte colony-stimulating agents (G-CSF). Generally, chemomobilization is employed for patients failing G-CSF and its most feared complication febrile neutropenia (FN)., Materials and Methods: Here, we aimed to investigate the impact of the FN in chemomobilization on apheresis outcomes and engraftment. One hundred and eighty-three patients with the diagnosis of lymphoma or myeloma who underwent chemomobilization between 2015 and 2020 were included in the study., Results: Forty-three patients experienced FN. All patients received G-CSF. All myeloma patients were mobilized with 4 g/m 2 cyclophosphamide, but it was heterogeneous for lymphoma patients. The precollection blood counts, harvested CD34+ hematopoietic stem cells (HSCs)/kg, apheresis count, and engraftment durations were recorded. Preapheresis leukocyte and platelet were lower in the FN group ( P = 0,004 and P = 0,001). Peripheral CD34 HSCs and total harvested CD34 HSCs were similar among groups ( P = 0.25 and P = 0.9). More apheresis was needed in the FN group, but it was not significant ( P = 0.07). Undergoing ASCT was similar ( P = 0.7); however, platelet and neutrophil engraftment durations were slower in the FN group ( P = 0.05 and P = 0.001)., Conclusion: Harvesting sufficient CD34+ HSCs from patients with FN is still feasible; however, FN treatment should begin promptly, and further apheresis sessions may be required., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Asian Journal of Transfusion Science.)