The prognostic impact of blood transfusion in multiple myeloma (MM) remains uncertain, with limited data, particularly from the Indian subcontinent. This study evaluated the association of transfusion requirements with Revised International Staging System (RISS) stage, progression-free survival (PFS), and overall survival (OS) in MM patients undergoing chemotherapy. We conducted a retrospective observational study of newly diagnosed MM patients receiving chemotherapy between January 2012 and March 2023 at a tertiary care center, excluding those undergoing stem cell transplantation. Patients were stratified into two cohorts: < 5 units versus ≥ 5 units of packed red cells and/or platelets received during induction, consolidation, and maintenance. Clinical, laboratory, and treatment characteristics were compared, and survival outcomes were analyzed using log-rank tests and Cox regression. Of 44 patients (mean age 63.7 ± 10.4 years, male: female ratio 1.4:1), 20 (45.5 %) received ≥ 5 transfusions. This cohort had significantly higher RISS stage (p = 0.038), more relapses (p = 0.008), and greater need for multiple chemotherapy regimens (p = 0.02). Patients receiving < 5 transfusions demonstrated significantly longer PFS (p = 0.013). Spearman correlation showed a positive association between transfusion number and RISS stage (r = 0.6, p < 0.05), while transfusion burden negatively correlated with both PFS and OS. Our findings suggest that higher transfusion may be a prognostic risk factor inversely affecting PFS and OS in multiple myeloma patients undergoing chemotherapy.

High-volume plasma exchange (HVP) has been proposed as an adjunctive therapy for acute liver failure (ALF), with prior randomized trials showing improved transplant-free survival. We conducted a retrospective, single-center study of 45 acute liver failure patients who received HVP at the Poison Control Center, Bach Mai Hospital, Hanoi, Vietnam, to describe the 28-day outcomes, treatment-related complications, and factors associated with survival. Patient variables including age, gender, etiology, survival at 28 days, international normalized ratio (INR), plasma volume per exchange, hospital stay, and complications were collected. Data were analyzed using SPSS 27. Descriptive statistics (mean ± SD, median ± IQR) were applied, and INR was compared between survivors and non-survivors using t-test (p < 0.05). The mean age was 47 ± 16 years; 24 (53.3 %) were male. Leading etiologies were traditional medicine/herbal use 22(48.9 %), paracetamol 9(20.0 %), and other causes 14(31.1 %). The 28-day survival rate was 53.3 % (24/45). Mean INR at admission was 3.30 ± 2.45; survivors had lower INR (2.67) than non-survivors (4.02), though not statistically significant (p = 0.082). Each HVP used a mean plasma volume of 8.27 ± 1.19 L. Mean hospital stay was 9.8 ± 7.3 days. Complications included anaphylaxis/allergic reactions in 13 (28.9 %) and bleeding in 2 (4.4 %), while no complications occurred in 30 (66.7 %) patients. In this cohort, HVP (mean 8.27 L per exchange) was associated with a 28-day survival rate of 53.3 %, comparable to that reported in previous studies, though causality cannot be inferred due to the absence of a control group. Our findings highlight the high prevalence of ALF from traditional medicine in Vietnam and support the need for prospective, multicenter studies to refine prognostic factors and optimize HVP protocols. These results support the use of HVP as a feasible and safe supportive therapy in resource-limited settings.Limitationsin our study include the retrospective design, single-center setting, small sample size, and absence of a control group. This study was approved by the Institutional Ethics Committee of Bach Mai Hospital, Hanoi, Vietnam.

The therapeutic use of blood changed profoundly after the Spanish Civil War (1936-1939) and the Second World War (1939-1945). This article examines the transformation of transfusion medicine in Spain during the early Franco regime and the pivotal role of Josep Antoni Grifols i Lucas (1917-1958). The Barcelona-born physician conducted pioneering studies on the safety of apheresis techniques, establishing its secure industrial application. In a context marked by autarky and technological scarcity, this method enabled a more efficient use of blood transfusions and laid the foundations of the plasma derivatives industry in Spain. Through the creation of Laboratorios Grifols S.A. within a very specific political and industrial context, the article shows how a key medical technique that would shape contemporary transfusion medicine emerged.

Colchicine is a narrow therapeutic index drug widely used in the treatment of inflammatory diseases such as acute gout attacks and Familial Mediterranean Fever (FMF). In case of overdose, the risk of toxicity is high and can rapidly lead to multiple organ failure. The lack of an antidote for colchicine toxicity continues the search for a definitive treatment. We present a case of severe colchicine toxicity managed successfully with early initiation of therapeutic plasma exchange (TPE), intensive supportive care including noninvasive ventilation, hemodynamic stabilization, electrolyte management, and granulocyte colony- stimulating factor (G-CSF) therapy. This multimodal intensive care approach resulted in complete recovery.

Thalassemia, a hemoglobin disorder, represents a considerable public health challenge in Iraq. Although blood transfusion is crucial for the survival of β-thalassemia patients, it is associated with health problems, including alloimmunization. This study aimed to investigate the prevalence of alloimmunization rate and identify the types of alloantibodies present in β-thalassemia patients in Wasit province, Iraq.

Red blood cell (RBC) alloimmunization is a clinically important complication in transfusion-dependent patients, particularly those with hemoglobinopathies and hematologic malignancies. It increases the risk of hemolytic reactions and complicates transfusion support. Despite the high alloimmunization rate in tranfusion-dependent patients in Saudi Arabia, most existing studies remain observational and lack an actionable predictive framework.This study aimed to develop a multivariate predictive model and a simplified risk scoring system to forecast alloimmunization risk in transfusion recipients at King Abdulaziz University Hospital (KAUH), Jeddah.

The vein-to-vein transfusion chain consists of two distinct elements - To allow consistent preparation and use of blood components that are safe and clinically efficacious, an appropriate and transparent quality system should be put in place that covers both the management, as well as the technical operations of facilities involved in the chain and leads to the development of a quality culture and sustained stewardship in transfusion medicine. This article describes and discusses the different managerial and operational systems available and their applicability in transfusion medicine; how to master and sustain.

The monocyte monolayer assay (MMA) is a key method for predicting the clinical significance of red blood cell (RBC) antibodies. However, its broader implementation is hindered by the challenge of securing a sustainable peripheral blood mononuclear cell (PBMC) source. We assessed plateletpheresis by-products as an alternative PBMC source for MMA and applied the established MMA to assess the clinical significance of anti-Di antibodies.

To investigate association between fresh frozen plasma transfusion within 24 h of admission and 28-day mortality, in-hospital mortality and multiple organ dysfunction syndrome (MODS) in pediatric patients with sepsis.

Granulocyte transfusion (GTX) is a significant adjunctive treatment for patients with refractory infections and severe neutropenia. High-dose granulocyte concentrates are best collected by optimized mobilization and apheresis techniques. Among the most popular platforms, COBE Spectra and Spectra Optia differ in terms of technology and operational characteristics; however, comparative data from Indian settings are limited.

To develop and validate a prediction model integrating laboratory parameters and thromboelastography (TEG) for forecasting blood transfusion needs in orthopedic surgery.

Timely administration of blood products is critical in trauma resuscitation. Many trauma centers worldwide do not store blood products within the emergency room (ER), potentially delaying transfusion. This study evaluated the impact of immediate availability of uncrossmatched O-type packed red blood cells (UORBC) in the trauma bay on patient management and outcomes.

We discovered a young male with normal conventional coagulation test results but abnormal Thromboelastography (TEG) results, ultimately identifying acquired Factor ⅩⅢ (FⅩⅢ) deficiency. Initial whole blood TEG revealed a normal reaction time (R) (6 min), prolonged kinetic time (K) (4.9 min), and reduced maximum amplitude (MA) (36.3 mm). The antigenic pFⅩⅢ-A subunit level was 2.8 %. By mixing normal pooled plasma (NPP; fibrinogen: 4.91 g/L) and the patient's plasma (fibrinogen: 4.85 g/L) in various ratios, we observed a correlation between FⅩⅢ-A levels (ranging from 2.8 % to 89.3 %) and TEG parameters. MA and angle showed strong correlations with FⅩⅢ-A levels. To determine the presence of an FXⅢ inhibitor in the patient's serum, experimental samples were prepared by mixing plasmas from seven healthy volunteers (with varying fibrinogen levels) with the patient's serum at initial diagnosis in a 1:1 ratio, while control samples consisted of the same healthy plasmas mixed with serum from a healthy volunteer. TEG analysis of the mixtures demonstrated a significantly lower MA in the experimental group compared to the control group (p < 0.05), indicating the presence of FXIII inhibitor. Based on this case, we explored the correlation between FⅩⅢ levels and TEG parameters, and developed a TEG-based screening method for FⅩⅢ inhibitors.

Ionized calcium [Ca ] is the free active form found in circulation used to monitor a patient's calcium during therapeutic plasma exchange (TPE). Hypocalcemia during TPE is caused by citrate anticoagulation. Citrate toxicity can be mitigated by calcium supplementation; however, there is no standard protocol for its use. We describe our institutional experience using calcium supplementation during TPE.