Platelet and Red Blood Cell Transfusions and Risk of Acute Graft-versus-Host Disease after Myeloablative Allogeneic Hematopoietic Cell Transplantation

Effect of major ABO blood group mismatched HSCT on blood transfusion and clinical outcomes in AA patients

To investigate the impact of the ABO blood group major match type on stem cell engraftment, blood transfusion and clinical outcomes in aplastic anemia patients with hematopoietic stem cell transplantation (HSCT), we retrospectively analyzed the data of 361 aplastic anemia patients treated with HSCT, and found ABO major mismatched resulted in delayed red blood cells (RBCs) engraftment and ABO blood group conversion. The patients in the ABO major mismatched group required more units of RBCs and PLTs transfusions. Multivariate linear regression analysis showed that ABO mismatched, acute graft-versus-host disease (aGVHD), time to RBCs and PLTs engraftment and blood group conversion, and baseline hemoglobin were significantly associated with RBCs transfusion, the factors associated with PLTs transfusion were the PLTs, RBCs and neutrophils engraftment, graft rejection, baseline PLTs, aGVHD grade II-IV, and severe chronic GVHD. Multivariate analysis showed that the time to neutrophils engraftment, baseline hemoglobin, and aGVHD were independent poor prognostic factors to both overall survival and failure-free survival. Moreover, the major ABO-mismatched HSCT group were hospitalized more often. These findings suggest that it's better to select a donor with an ABO major match to reduce the burden of transfusion and the impact of hospitalization, if conditions permit.

Cell Therapy as a Way to Increase the Effectiveness of Hematopoietic Stem Cell Transplantation

Hematopoietic stem cell transplantation (HSCT) is a standard method for treating a number of pathologies, primarily blood diseases. Timely restoration of the immune system after HSCT is a critical factor associated with the development of complications such as relapses or secondary tumors and various infections, as well as the graft-versus-host reaction in allogeneic transplantation, which ultimately affects the survival of patients. Introduction into the recipient's body of immune system cells that are incapable of sensitization by recipient antigens during the period of immune reconstitution can increase the rate of restoration of the immune system, as well as reduce the risk of complications. This review presents the results of studies on cell therapy with various cell subpopulations of both bone marrow and mesenchymal origin during HSCT.

Patient Blood Management in Liver Transplant—A Concise Review

Transfusion of blood products in orthotopic liver transplantation (OLT) significantly increases post-transplant morbidity and mortality and is associated with reduced graft survival. Based on these results, an active effort to prevent and minimize blood transfusion is required. Patient blood management is a revolutionary approach defined as a patient-centered, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient’s own blood while promoting patient safety and empowerment. This approach is based on three pillars of treatment: (1) detecting and correcting anemia and thrombocytopenia, (2) minimizing iatrogenic blood loss, detecting, and correcting coagulopathy, and (3) harnessing and increasing anemia tolerance. This review emphasizes the importance of the three-pillar nine-field matrix of patient blood management to improve patient outcomes in liver transplant recipients.

Platelet-to-Lymphocyte Ratio as an Independent Factor Was Associated With the Severity of Ankylosing Spondylitis

The study was aimed to determine the association of the platelet-lymphocyte ratio (PLR) with the disease activity of ankylosing spondylitis (AS). A total of 275 patients, including 180 AS patients and 95 non-AS patients, participated in the study. We assessed a full blood count for each participant. Platelet to monocyte ratio (PMR), monocytes to lymphocyte ratio (MLR), monocyte to neutrophil ratio (MNR), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and platelet to neutrophil ratio (PNR) were calculated. LASSO and logistic regression analyses were performed to establish the nomogram. Receiver operating characteristic (ROC) analysis was performed to evaluate the clinical value of the nomogram. We constructed a novel nomogram, which incorporated easily accessible clinical characteristics like sex, PLR, WBC, EOS, and ESR for AS diagnosis. The AUC value of this nomogram was 0.806; also, the calibration curves indicated a satisfactory agreement between nomogram prediction and actual probabilities. Furthermore, PLR was positively correlated with the severity of AS. PLR was identified as an independent factor for the diagnosis of AS and was associated with the severity of AS.