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Transfusion Medicine and Blood: Current Clinical Status and Future Challenges

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Hematology".

Deadline for manuscript submissions: closed (25 January 2024) | Viewed by 10459

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Special Issue Editors

Dr. Lucia Merolle

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Guest Editor

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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

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Research

12 pages, 1576 KiB

Open AccessArticle

Reduction of EpCAM-Positive Cells from a Cell Salvage Product Is Achieved by Leucocyte Depletion Filters Alone

by Lucia Merolle, Davide Schiroli, Daniela Farioli, Agnese Razzoli, Gaia Gavioli, Mauro Iori, Vando Piccagli, Daniele Lambertini, Maria Chiara Bassi, Roberto Baricchi and Chiara Marraccini

J. Clin. Med. 2023, 12(12), 4088; https://doi.org/10.3390/jcm12124088 - 16 Jun 2023

Cited by 1 | Viewed by 1931

Abstract

Intraoperative cell salvage reduces the need for allogeneic blood transfusion in complex cancer surgery, but concerns about the possibility of it re-infusing cancer cells have hindered its application in oncology. We monitored the presence of cancer cells on patient-salvaged blood by means of flow cytometry; next, we simulated cell salvage, followed by leucodepletion and irradiation on blood contaminated with a known amount of EpCAM-expressing cancer cells, assessing also residual cancer cell proliferation as well as the quality of salvaged red blood cell concentrates (RBCs). We observed a significant reduction of EpCAM-positive cells in both cancer patients and contaminated blood, which was comparable to the negative control after leucodepletion. The washing, leucodepletion and leucodepletion plus irradiation steps of cell salvage were shown to preserve the quality of RBCs in terms of haemolysis, membrane integrity and osmotic resistance. Finally, cancer cells isolated from salvaged blood lose their ability to proliferate. Our results confirm that cell salvage does not concentrate proliferating cancer cells, and that leucodepletion allows for the reduction of residual nucleated cells, making irradiation unnecessary. Our study gathers pieces of evidence on the feasibility of this procedure in complex cancer surgery. Nevertheless, it highlights the necessity of finding a definitive consensus through prospective trials. Full article

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

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11 pages, 627 KiB

Open AccessArticle

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

by Piotr F. Czempik, Dawid Wilczek, Jan Herzyk and Łukasz J. Krzych

J. Clin. Med. 2023, 12(4), 1293; https://doi.org/10.3390/jcm12041293 - 6 Feb 2023

Cited by 6 | Viewed by 2193

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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10 pages, 1090 KiB

Open AccessArticle

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

by Caterina Giovanna Valentini, Claudio Pellegrino, Rossana Putzulu, Matteo Bonanni, Giuseppina Massini, Nicoletta Orlando, Franca Forni, Maria Bianchi, Nicola Piccirillo and Luciana Teofili

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

Cited by 1 | Viewed by 2437

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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