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Article
Plateletpheresis concentrate produced with Fresenius cell separator Iraqi experience

Author: Nidal Karim Al-Rahal
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2012 Volume: 11 Issue: 1 Pages: 27-32
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Various types of plateletpheresis instruments are available for single donor plateletpheresis. In plateletpheresis blood is withdrawn from the donor in anticoagulant solution and separated into components. Platelets are retained and the remaining components are returned to the individuals.Aims: Evaluation of Fresenius COM.TEC; apheresis machine in regard to processing time, platelet (plt) yield efficiency, white blood cell (WBC) content and safety.Patients and Methods: Twenty two healthy male donors included in single donor plateletpheresis by Fresenius COM.TEC between February 2006 and July 2006 at bone marrow transplantation Center, Medical City Hospital, Baghdad / Iraq.The donor’s age, height, weight, complete blood count, blood group &Rh & vital signs were recorded and they were observed throughout the procedure. Plateletpheresis operational variables and the product variables were assessed.Results: The plateletpheresis product data which includes, donor platelet count with mean 229.424 x10³/cmm (range 185-336 x10³/cmm), product platelet count x10³/cmm mean 1268.5 x10³/cmm (range 604-2525 x10³/cmm), Platelet yield with mean 3.39 x10¹¹/cmm (range 2.51-7.57 x10¹¹/cmm), 90.90%of the product >3x10¹¹plt. No. of yield with WBC <1x106 18 out of 22 donors (81.18%), collection efficiency the mean 48,85% (range 32.18-60.28), the collection efficiency >50% was seen in 13 out of 22 donors (59.09%).Few donors exhibited adverse reactions mainly circumoral paresthesia in two donors (9.09%) mild pain at the phlebotomy site in three donors (13.63%). Only one had dizziness which account for 4.54%.Conclusions: Fresenius COM.TEC; apheresis instrument collected platelets safely, efficiently, with consistent leukoreduction product according to the AABB (American Association of Blood Banks) & with short time.


Article
Bacterial contamination in platelet concentrates versus single donor plateletpheresis

Authors: Nidal Karim Al-Rahal --- Fatma Abd Al Hamza --- Jawad K Mashaali
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2016 Volume: 29 Issue: 3 Pages: 173-177
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Transfusion of platelets is commonly indicated in patients with thrombocytopenia due to hematological or oncological diseases. These platelets are obtained either through apheresis from a single donor or derived from the whole blood of several donors. The risk of bacterial infections with platelet transfusions is increased due to platelet storage at 22 C̊ rather than the 4 C̊ required by red cells.Aim: to determine the prevalence of bacterial contamination in platelet units either of random platelet concentrates or single donor platelets and to establish a strategy to reduce the risk of platelet unit’s contamination to limit and eventually prevent transfusion of bacterially contaminated units.Material and Methods: This study was conducted in the National Center of Hematology Al-Mustaniriyah university during the period from 2nd of January till the end of May 2013 a total of 150 platelet donors, 100 random platelet concentrates derived from whole blood received from National Blood Bank in Baghdad of different donors &50 single donor platelets leukodepleted obtained from a single donor by apheresis using Haemonetics (MCS +) cell separator machine. Platelet bacterial contamination was studied by prospective (active) measure for five months. From all the 150 platelet units Gram stain &culture were done.Results: Positive Gram stain was observed in 13(13%) of random donor platelet samples,7 units of random donor platelet (7%) samples yield positive culture (true positive rate )and 6 units of random donor platelet (6%) yield negative culture results (false positive rate) .Microscopy stain was negative in 87 samples, of which 8(8%) yield positive culture (false negative rate) and 79(79%) produce negative Gram stain & culture. No positive Gram stain noticed in all 50 single donor platelet samples otherwise positive culture observed in one sample. The sensitivity of Gram stain was o.46%. Culture were positive 15(15%) of random donor platelets units and one (2%) of single donor platelets units with P- value 0.026. fourteen of random donor platelet units were found to be positive for bacterial growth, with coagulase-negative staphylococcus species 93.33%, plus one gram-negative rod (Klebsiella pneumonia) 6.67% .From the second group of 50 single donor platelet units, 1 of PLT units was found to be positive for bacterial growth, with coagulase-negative Staphylococcus species 100% . Conclusion: The use of single donor platelet s is a simple measure to reduce platelet unit’s contamination which is high in Iraq. Other measures will be required to eliminate all platelet units’ contamination


Article
Incidence of Epstein Barr Virus infection in newly diagnosed non-Hodgkin lymphoma in the national center of hematology-single center study
نسبة حدوث عدوى فيروس ابشتاين بار(EBV) في المرضى المشخصين حديثا بمرض ورم الغدد اللمفاويية اللاهوجكني في المركز الوطني لامراض الدم في بغداد

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Abstract

Background: Non Hodgkin lymphoma (NHL) is a diverse group of disorders both in their original history and in response to therapy .The appearance of Epstein-Barr infection (EBV) in Non-Hodgkin’s lymphoma (NHL) could be distinguished by enzyme link immune sorbent assay by detecting IgM and IgG. The role of EBV as causative agent for non-Hodgkin lymphoma has been supported by identification of large amounts of latent membrane protein 1 (LMP-1) outflow in tumors. The aim: of this study was to determine the incidence of EBV infection in patient with newly diagnosed patients with non-Hodgkin lymphoma. Materials and Methods: This study was done at the Department of clinical hematology, the national center of hematology (NCH), Baghdad, Iraq from August 2012 to November 2013. It is a prospective study. A total of 56 patients with age ranged from 18 – 56 years were included. They were diagnosed with NHL and then classified to subtypes by studying histopathology and immunohistochemistry. Assessment of EBV IgM and IgG were done by ELISA technique. A second group comprised of 22 patients with non-malignant condition regarded as control group with matched sex and age. Statistical analysis was performed utilizing SPSS version 17.0.Result: Mean age of the patients was 51.44±15.93 years. Thirty-six (70.4%) were males and 20 (29.6%) were females. Seven (12.5%) out of 56 cases were positive for EBV–IgM, two cases (28.5%) were follicular lymphoma, 5 cases (71.5%) were diffuse large B cell lymphomas. For the EBV-IgG 12 patients (21.4%) were negative while majority 44 patients (78.6%) were positive, in comparison to control group the result was statistically not significant.Conclusion: This study showed that the age, sex and clinical characteristics of Iraqi patients with NHL are different from those of surrounding countries and. The incidence of EBV is high in NHL. The most frequent subtype of NHL is diffuse large B cell lymphoma.

خلفية: ورم الغدد اللمفاويية اللاهوجكني هو سرطان الغدد الليمفاوية و هو مجموعة متنوعة من الاعراض التي تصيب الاشخاص و تتنوع سواء في تاريخ المرض الأصلي والاستجابة للعلاج .ان ظهور و اكتشاف الإصابة بابشتاين بار ( EBV ) في ورم الغدد اللمفاويية اللاهوجكني يمكن تمييزها عن طريق فحص بتقنية الاليزا حيث يتم اكتشاف الغلوبولين المناعي.. وقد تم دعم دور EBV كمسبب للمرض أو في نشوء ورم الغدد اللمفاويية اللاهوجكني عن طريق تحديد كميات كبيرة من البروتين الغشاء الكامنة 1 ( LMP- 1 )..الهدف: كان الهدف من هذه الدراسة تحديد معدل عدوى انتشار فيروس ابشتاين بار EBV في المرضى المشخصين حديثا بمرض ورم الغدد اللمفاويية اللاهوجكني في المركز الوطني لامراض الدم في بغداد.المواد و الطرق: أجريت هذه الدراسة في قسم أمراض الدم السريرية، في المركز الوطني لأمراض الدم ( NCH ) ، بغداد، العراق من أغسطس 2012 إلى نوفمبر 2013. وكانت دراسة استطلاعية . ما مجموعه 56 من المرضى الذين يعانون من ورم الغدد اللمفاويية اللاهوجكني تراوحت اعمارهم ما بين 18-56 عاما. تم التشخيص والتصنيف إلى أنواع فرعية من خلال دراسة التشريح المرضي و المناعية. وقد أجريت تقييم EBV الغلوبولين المناعي بواسطة تقنية .ELISA المجموعة الثانية تتكون من 22 مريض مشخصين بحالة غير خبيثة وتعتبر المجموعة الضابطة المتطابقة مع الجنس والعمرلمرضى ورم الغدد اللمفاوية. تم إجراء التحليل الإحصائي باستخدام التكيف SPSSالنتائج: كان متوسط عمر المرضى 51.44 ± 15.93 عاما. 36 مريضا ( 70.4 ٪ ) كانوا من الذكور و 20 مريضا ( 29.6 ٪ ) من الإناث . سبعة ( 12.5 ٪ ) من أصل 56 حالة كانت إيجابية لل EBV - الغلوبولين المناعي ، و 2 من الحالات ( 28.5 ٪ ) كان تشخيصها لمفوما جريبية ، 5 حالات ( 71.5 ٪ ) تم تشخيصا بالأورام اللمفاوية ذات خلية كبيرة . كانت نتيجة EBV IgG- لاثنا عشر مريضا ( 21.4 ٪ ) سلبية في حين كانت الغالبية 44 مريضا ( 78.6 ٪ ) إيجابية ، و بالمقارنة مع المجموعة الضابطة كانت النتيجة إحصائيا غير ذات دلالة .الاستنتاج : ان عدوى انتشار فيروس ابشتاين بارEBV في مرض ورم الغدد اللمفاويية اللاهوجكني هو شائع مع نسبة انتشار تساوي 12.5 ٪ و بصورة عامة فهي شائعة في النوع المعروف ب ورم اللمفاوي ذات الخلية الكبيرة (ب). بينما غالبية المرضى مع NHL تحمل EBV IgG .

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