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Introduction Gestational anaemia, which has specific haemoglobin (Hb) reference values in each trimester of gestation, increases the risk of maternal mortality and complications both in pregnancy and in the first months of the newborn's life. The objective of this study is to evaluate haemoglobin levels in pregnant women in our population, to determine the prevalence of gestational anaemia and to propose reference values specific to them. Material and methods Retrospective study of all blood counts requested in pregnancy and postpartum controls during 2019. Results 9995 gestation haemograms corresponding to 5507 pregnant women were reviewed. Of these, 1134 patients underwent complete follow-up in 2019. The prevalence data for anaemia were 1.8%, 11.8% and 13.2% in each trimester respectively, and the global prevalence in pregnancy was 22.6%. Regarding postpartum anaemia, its prevalence with respect to all pregnant women was 2.99%, increasing to 38.2% in those patients with complications during delivery. Conclusions The prevalence of gestational anaemia in our population is somewhat higher than in countries like ours. Therefore, there is room for improvement in our current clinical protocols. It is important to assess updating analytical controls with other more adequate parameters to determine iron reserves, as this is the main cause of anaemia.

Resumen Antecedentes y objetivos Los programas de Patient blood management (PBM) han demostrado su valor en la mejora continua de la practica asistencial, gracias a la revision sistematica de resultados y a su actualizacion dinamica y multidisciplinar, de acuerdo con las nuevas evidencias clinicas. Nuestro objetivo es demostrar la efectividad y seguridad de protocolos sencillos, aplicables en hospitales de segundo nivel. Pacientes y metodos Se han analizado retrospectivamente 702 pacientes intervenidos de artroplastia programada desde 2011 hasta 2018. Durante este periodo se ha registrado en la historia clinica de los pacientes la evolucion transfusional y el manejo de la anemia y el sangrado. Resultados Fases y tasas de transfusion: ano 2011-2012 «Programa autodonacion universal»: 62,4%; ano 2013 «inicio optimizacion de hemoglobina preoperatoria y retirada autodonacion universal» 22,5%; ano 2015 «suspension del uso de recuperadores y los drenajes» 13,2%; y ano 2017 «inicio de uso de acido tranexamico (ATX)» 3,6%. Se ha conseguido una reduccion significativa de la tasa y el numero de concentrados de hematies transfundidos (p Conclusion Un programa PBM sencillo, progresivo y multidisciplinar, con reevaluacion continuada, ha permitido reducir la transfusion y la estancia media hospitalaria en un hospital de segundo nivel.

The development of new therapies for COVID-19 high-risk patients remains necessary to prevent additional deaths. Here, we studied the phenotypical and functional characteristics of IFN-γ producing-SARS-CoV-2-specific T cells (SC2-STs), obtained from 12 COVID-19 convalescent donors, to determine their potency as an off-the-shelf T cell therapy product. We found that these cells present mainly an effector memory phenotype, characterized by the basal expression of cytotoxicity and activation markers, including granzyme B, perforin, CD38, and PD-1. We demonstrated that SC2-STs could be expanded and isolated in vitro, and they exhibited peptide-specific cytolytic and proliferative responses after antigenic re-challenge. Collectively, these data demonstrate that SC2-STs can be a suitable candidate for the manufacture of a T cell therapy product aimed to treat severe COVID-19.

Resumen Introduccion La infeccion por SARS-CoV-2 presenta gran heterogeneidad clinica, desde asintomatica hasta cuadros clinicos graves con un desenlace fatal. Algunos autores refieren el grupo sanguineo ABO como posible marcador biologico de susceptibilidad para la enfermedad. Pacientes y metodos Se ha recogido a los pacientes ingresados con infeccion por COVID-19 y se ha analizado la incidencia por grupos en relacion con la base poblacional de la Comunidad Foral de Navarra, asi como sus principales complicaciones y evolucion. Resultados Los pacientes de grupo O ingresados con infeccion por COVID-19 son proporcionalmente menos respecto a la base poblacional, sin ser la diferencia estadisticamente significativa. Los grupos AB y B son un 38% mas en el grupo de infectados que en la poblacion. El grupo B ha presentado significacion estadistica en cuanto al numero de complicaciones tromboticas junto con mayor tasa de ingreso en unidades de Cuidados Intensivos. Conclusion El estudio sugiere menor susceptibilidad a la infeccion de los pacientes de grupos O y mayor riesgo de complicaciones en el grupo B. Hacen falta estudios con mayor tamano muestral para poder obtener resultados significativos.

Introduction: Autoimmune thrombotic thrombocytopenic purpura (aTTP) is a severe disease caused by the production of autoantibodies against von Willebrand factor (vWF)-cleaving ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin-1 motifs; 13th member of the family). Without functional ADAMTS13, endothelial cells-derived unusually large vWF (ULVWF) multimers are present and are responsible for platelet clumping in the microvasculature. Plasma exchange (PE) and immunosuppressive therapy with steroids and rituximab are the milestones of the treatment of this disease. Moreover, in 2018, nanobody caplacizumab was approved for the treatment of adult patients with an acute episode of aTTP. Our objective was to retrospectively review the efficacy and safety of the current use of caplacizumab in Spain. Methods: We collected demographic, clinical, and laboratory data of patients with aTTP who were reported in the TTP Spanish Registry from 15 centres between July 2018 and July 2020. All patients were diagnosed with aTTP because of the presence of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, organ dysfunction, ADAMTS13 activity less than 5% and the presence of ADAMTS13 autoantibodies. Qualitative data are presented as number (frequencies). Quantitative data are presented as mean ± standard deviation (SD) or median (interquartile range -IQR-) when appropriate. A correlation test was performed to determine the linear relationship between number of days since diagnosis to caplacizumab start and number of days since diagnosis to the first day with >150x109/L platelets. Results: Our series comprises 30 patients: 22 (73%) females and 8 (27%) males with a median age of 45 (IQR: 31-55). At presentation, neurologic abnormalities were seen in 18 (60%) patients, symptoms and signs of anemia were present in 15 (50%) patients, and bleeding was present in 10 (33%) patients. Fever was present in 1 (3%) patient. Laboratory tests showed hemoglobin 92±28 g/L, platelet count 19±16 x109/L, unconjugated bilirubin 2.33±1.76 mg/dL, LDH 1,467±1,428 IU/L, and creatinine 1.0±0.45 mg/dL. Median ADAMTS13 activity was 0 (IQR: 0-0.5) and ADAMTS13 autoantibodies were positive in all cases. After diagnosis, treatment was started with PE and steroids in all patients after a median of 0 days (IQR: 0-0) and patients received a median of 10 PE procedures (IQR: 7-13). Caplacizumab was administered to all patients with a median of 3 (IQR: 1-9) days after diagnosis and it was administered during 36 days (IQR: 31-39). No severe adverse events were reported with the use of caplacizumab. Rituximab was added in 19 (63%) patients after a median of 4 days (IQR: 14-21). Time to platelet normalization (>150x109/L) was 5.5 days (IQR: 4-17) after diagnosis. The longer the delay in administering caplacizumab after diagnosis, the longer the delay in platelet normalization (Pearson's correlation coefficient, r=0.94 (95% CI: 0.86 to 0.98; R2=0.89; p Conclusion: Caplacizumab was an efficacious and safe drug to treat adult patients with acute episodes of aTTP. A statistically significant strong positive linear correlation was observed between number of days from diagnosis to caplacizumab start and number of days from diagnosis to the first day with >150x109/L platelets. Disclosures No relevant conflicts of interest to declare.

The "Patient Blood Management" (PBM) programmes have demonstrated their value in the continuous improvement of care practice, due to continuous systematic reviewing of results and their dynamic and multidisciplinary updating in accordance with new clinical evidence. Our goal is to demonstrate the effectiveness of simple protocols, applicable in second level hospitals.702 patients undergoing scheduled arthroplasty from 2011 to 2018 were retrospectively analysed. During this period, the evolution of transfusion rates and anaemia and bleeding management were recorded in the patients' computerised clinical histories.Stages and transfusion rates were: Year 2011-2012, "Universal self-donation programme": 62.4%; year 2013, "Optimization of preoperative haemoglobin and universal self-donation withdrawal", 22.5%; year 2015, "Stopping the use of cell-savers and drains", 13.2%; and year 2017, "Introduction of routine tranexamic acid", 3.6%. A significant reduction in the transfusion rate and volume (P.001) and the average hospital stay (8 to 6 days) (P.001) was achieved. In multivariate models, transfused patients have a .5-day stay and there is a trend towards a reduction in complications, being fewer in patients receiving tranexamic acid (OR .44).A simple progressive and multidisciplinary PBM programme, with continued re-evaluation, has allowed a reduction in transfusion rates and average hospital stay.

Plerixafor (PLX) appears to effectively enhance hematopoietic stem-cell mobilization prior to autologous hematopoietic stem cell transplantation (auto-HCT). However, the quality of engraftment following auto-HCT has been little explored. Here, engraftment following auto-HCT was assessed in patients mobilized with PLX through a retrospective, multicenter study of 285 consecutive patients. Information on early and 100-day post-transplant engraftment was gathered from the 245 patients that underwent auto-HCT. The median number of PLX days to reach the stem cell collection goal (≥2 × 106 CD34+ cells/kg) was 1 (range 1-4) and the median PLX administration time before apheresis was 11 h (range 1-18). The median number of apheresis sessions to achieve the collection goal was 2 (range 1-5) and the mean number of CD34+ cells collected was 2.95 × 106/kg (range 0-30.5). PLX administration was safe, with only 2 mild and transient gastrointestinal adverse events reported. The median time to achieve an absolute neutrophil count (ANC) >500/μL was 11 days (range 3-31) and the median time to platelet recovery >20 × 103/μL was 13 days (range 5-69). At 100 days after auto-HCT, the platelet count was 137 × 109/L (range 7-340), the ANC was 2.3 × 109/L (range 0.1-13.0), and the hemoglobin concentration was 123 g/L (range 79-165). PLX use allowed auto-HCT to be performed in a high percentage of poorly mobilized patients, resulting in optimal medium-term engraftment in the majority of patients in whom mobilization failed, in this case mainly due to suboptimal peripheral blood CD34+ cell concentration on day +4 or low CD34+ cell yield on apheresis.

Plerixafor (Mozobil, Sanofi) is approved for using in patients with lymphoma and multiple myeloma when steady-state mobilization strategies fail. Although off-label use of plerixafor in healthy related donors (HRD) is known, limited data are available and no recommendations exist to guide its use in this setting. With the aim of collecting data from HRDs who received plerixafor in our country, we designed an observational case series study within the Spanish Group of Hematopoietic Transplant and Cell Therapy (GETH). Plerixafor was administered subcutaneously to 30 HRDs at a median dose of 0.24 mg/Kg (interquartile range (IQR): 0.23-0.25) because mobilization failure after using mobilization with G-CSF (mobilization failure was defined as collection of

Platelets are stored routinely for 5 days or less and extended platelet storage time could improve product availability. This study compared platelet count increments (CI24hs) of riboflavin plus UV-light (PRT) treated platelet products in platelet additive solution stored for 5 days or less to products stored for 6-7 days.This was a retrospective study comparing CI24hs between two groups. Hematology patients received PRT treated platelet products stored for5 days, or for 6-7 days. Platelet counts and adverse events during and up to 24 hours after transfusion were recorded and compared between the groups.Ninety-seven patients received 168 transfusions of5 day old PRT-treated platelets and 49 patients received 74 transfusions of 6-7 day old PRT-treated platelets. There was no statistically significant difference in CI24hs between the5 day (median 6000) and 6-7 day storage group (median 8000) (p-value = 0.509). One mild fever was documented in the5 day storage group.CI24hs are similar for PRT-treated PLTs stored in PAS for5 or 6-7 days. Studies to further evaluate clinical outcomes such as bleeding are ongoing.

Peripheral blood progenitor cells (PBPCs) have become the major source of hematopoietic progenitor cells for allogeneic transplantation. In February 2008, Zarzio® was approved by the European Medicine Agency for PBPCs mobilization, but this authorization was not based in trials analyzing safety and efficacy for PBPCs mobilization. Since August 2011, Zarzio® has been used at our institution for PBPCs mobilization. In total 36 healthy family donors underwent PBPCs mobilization, 18 with Neupogen® and 18 with Zarzio®. Donor characteristics were equivalent between groups, and no severe adverse effects were registered in the Zarzio® group. The number of CD34 cells collected/Kg recipient body weight was 6.7 × 106 (3.8–11.1) in the Zarzio® group versus 8.4 × 106 (5.6–16.6) in the Neupogen® group (P = 0.04). We collected the minimal target cell dose (2 × 106/kg) in all donors from each group and no significant differences were found in the collection of the optimal cell dose (5 × 106/kg) between groups, although 3/18 (16.6%) donors that received Zarzio® failed to mobilize the optimal cell dose compared with 0% in the Neupogen® group. A total of 35 patients proceeded to transplantation (17 in the Zarzio® and 18 in the Neupogen® groups, respectively). Platelet and neutrophil median time to engraftment was comparable between the two groups. Our retrospective study supports the conclusion that Zarzio® mobilization of PBPCs in healthy donors is safe but perhaps not as effective as the reference Neupogen. However, more prospective trials are required to definitively asses the safety and efficacy of G-CSF biosimilars for PBPCs mobilization in healthy donors. J. Clin. Apheresis 31:48–52, 2016. © 2015 Wiley Periodicals, Inc.