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Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
Interests: biochemistry; immunohaematology; platelet-based therapies; red blood cells; cancer-related anemia; blood donation; transfusion; cell biology; ion homeostasis; blood disorders

Dr. Chiara Marraccini

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Guest Editor

Transfusion Medicine Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
Interests: biochemistry; immunohaematology; therapeutic apheresis; patient blood management; red blood cells; cancer-related anemia; blood donation; transfusion; cell biology; rare blood types; intraoperative blood salavage

Special Issue Information

Dear Colleagues,

Transfusion Medicine is an ever-developing science, which has made tremendous progress over the last century.

Recent years have seen changes in several aspects of blood transfusion, from collection through to delivery and administration. The 2020 pandemic impacted the supply and demand for blood, bringing transfusion service specialists to a new era of blood transfusion networks. The combined efforts of the scientific community, within translational and clinical research, evidence-based medicine and the hemovigilance initiative are contributing to improve both the blood supply chain and blood-based thearpies. New advances in Transfusion Medicine involve hematopoietic stem cell donation, advanced cell therapies, self-sufficiency in blood components and blood products, donor and patient blood management.

The aim of this Special Issue is to share new advances and future challenges in this field and we welcome authors to submit original articles, communications, clinical trials and reviews covering the entire field of Transfusion Medicine research, including (but not limited to):

Immunohematology
New advances in HCST transpantation
CAR-T
Blood donation
Transfusion therapy
Haemovigilance
Blood donor programs
Management of anemia
Transfusion in hemato-oncology
Platelet and Blood derivatives
Clinical application of blood derivative for non transfusional use
Patient Blood Management
Blood Bank
Diagnosis and treatment of blood disorders

Dr. Lucia Merolle
Dr. Chiara Marraccini
Guest Editors

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Keywords

blood donation
immunohematology
patient blood management
blood transfusion
HSC transplantation
transfusion therapy
transfusion medicine

Published Papers (2 papers)

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Research

Open AccessArticle

Appropriateness of Allogeneic Red Blood Cell Transfusions in Non-Bleeding Patients in a Large Teaching Hospital: A Retrospective Study

and

J. Clin. Med. 2023, 12(4), 1293; https://doi.org/10.3390/jcm12041293 - 06 Feb 2023

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Abstract

In hemodynamically stable patients, both anemia and red blood cell (RBC) transfusion may be detrimental to patients; hence, a decision regarding RBC transfusion should be based on thorough risk–benefit assessment. According to hematology and transfusion medicine organizations, RBC transfusion is indicated when recommended hemoglobin (Hb) triggers are met, and symptoms of anemia are present. The aim of our study was to examine the appropriateness of RBC transfusions in non-bleeding patients at our institution. We performed a retrospective analysis of all RBC transfusions performed between January 2022 and July 2022. The appropriateness of RBC transfusion was based on the most recent Association for the Advancement of Blood and Biotherapies (AABB) guidelines and some additional criteria. The overall incidence of RBC transfusions at our institution was 10.2 per 1000 patient-days. There were 216 (26.1%) RBC units appropriately transfused and 612 (73.9%) RBC units that were transfused with no clear indications. The incidence of appropriate and inappropriate RBC transfusions were 2.6 and 7.5 per 1000 patient-days, respectively. The most frequent clinical situations when RBC transfusion was classified as appropriate were: Hb < 70 g/L plus cognitive problems/headache/dizziness (10.1%), Hb < 60 g/L (5.4%), and Hb < 70 g/L plus dyspnea despite oxygen therapy (4.3%). The most frequent causes of inappropriate RBC transfusions were: no Hb determination pre-RBC transfusion (n = 317) and, among these, RBC transfused as a second unit in a single-transfusion episode (n = 260); absence of anemia sings/symptoms pre-transfusion (n = 179); and Hb concentration ≥80 g/L (n = 80). Although the incidence of RBC transfusions in non-bleeding inpatients in our study was generally low, the majority of RBC transfusions were performed outside recommended indications. Red blood cell transfusions were evaluated as inappropriate mainly due to multiple-unit transfusion episodes, absence of anemia signs and/or symptoms pre- transfusion, and liberal transfusion triggers. There is still the need to educate physicians on appropriate indications for RBC transfusion in non-bleeding patients. Full article

(This article belongs to the Special Issue Transfusion Medicine and Blood: Current Clinical Status and Future Challenges)

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Open AccessArticle

Day -1 CD34+ Cells and Platelet Count Predict the Number of Apheresis in Poor-Mobilizer Patients Rescued by Plerixafor

Caterina Giovanna Valentini

and

J. Clin. Med. 2023, 12(2), 618; https://doi.org/10.3390/jcm12020618 - 12 Jan 2023

Viewed by 604

Abstract

Plerixafor is widely used as up-front treatment with G-CSF to enhance peripheral blood hematopoietic stem cell output in patients failing previous mobilizations. Less frequently, plerixafor is used to rescue an unsatisfactory mobilization following chemotherapy (CT) and G-CSF. This study investigates if pre-collection factors affect the CD34+ cell harvest in chemotherapy and G-CSF mobilizations rescued by plerixafor. Clinical and hematological data relative to patients, mobilization, and apheresis products were retrospectively examined. The outcome was completing a target cell dose ≥ 2 × 10⁶ CD34+ cells/kg at first apheresis. The effect exerted on the outcome by patient- and disease-related factors was investigated by univariate and multivariate logistic regression analysis. The analysis included data from 42 patients affected by hematological (39 patients) and non-hematological malignancies (three patients). Twenty-nine patients (69%) attained the target cell dose at first apheresis. Twelve out of the remaining 13 patients received an additional plerixafor administration, and all accomplished the transplant dose at a second apheresis procedure. Day -1 CD34+ PB count (OR1.46, 95% CI 1.1–1.9, p = 0.008) and platelet count (OR1.0, 95% CI 1.0–1.0, p = 0.033) predicted the achievement of the target dose at first apheresis, independently of pre-mobilization CT, radiation therapy, and disease status at mobilization. At ROC curve analysis, the best cut-off value predicting the successful collection at first apheresis was 7.5/µL for Day -1 CD34+ cell count (AUC 0.830, 0.69 sensitivity, and 0.92 specificity) and 75 × 10⁹/L for Day -1 platelet count (AUC = 0.736, 0.65 sensitivity and 0.85 specificity). In conclusion, on-demand plerixafor rescue allows a successful stem cell collection, irrespectively of disease type and status, prior CT lines, and radiation exposure. Pre-apheresis CD34+ cells and platelet count predict the need for one or two aphereses. Full article

(This article belongs to the Special Issue Transfusion Medicine and Blood: Current Clinical Status and Future Challenges)

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