Alamin MustafaFaculty of Medicine, Al-Neelain University, Khartoum, Khartoum State, SudanCorrespondence: Alamin Mustafa, Faculty of Medicine, Al-Neelain University, Khartoum, Khartoum State, Sudan, Email alamin900005@gmail.comIntroduction: Hairy cell leukemia (HCL) is a rare lymphoproliferative disorder affecting mature B-cells, predominantly observed in males. It is recognized by cytopenia, splenomegaly, myelofibrosis, and the presence of atypical lymphoid cells exhibiting distinctive cytoplasmic hairy projections.Methods: This large updated population-based study utilized SEER database to evaluate 5669 hairy cell leukemia (HCL) patients diagnosed between 1978 and 2020. Univariate and multivariate Cox proportional hazards models were performed to identify key determinants of overall survival (OS). While the SEER database provides robust statistical power and broad generalizability, this analysis is inherently limited by registry-level constraints, including missing treatment details (such as specific chemotherapy regimens or lines of therapy), lack of relapse/progression data, and potential underreporting of comorbidities.Results: Estimated median survival for HCL patients who aged less than 40 years was 39.3 (95% CI: 38.9– 39.7 years) compared to 8.8 years (95% CI: 8.0– 9.4 years) for HCL patients older than 65 years.Conclusion: This study demonstrates favorable long-term survival among patients with HCL. Improved OS is associated with more recent diagnosis (post-2006) and the use of advanced diagnostic methods. These findings suggest that long-term survival in HCL may approach that of the general population, though these findings reflect cohort-level observations without a matched population control.Keywords: neoplasm, leukemia, hairy cell leukemia, prognostic factors, overall survival
Janet S Lee, Fadoua El Moustaid, Lucy Y LeeGenentech, Inc., South San Francisco, CA, USACorrespondence: Janet S Lee, Genentech, Inc., 1 DNA Way, South San Francisco, CA, 94080, USA, Tel +1-650-255-5036, Email lee.janet@gene.comBackground: Emicizumab, a recombinant, humanized, bispecific, monoclonal antibody, has become the standard of prophylactic care for people with hemophilia A since its US approval in 2017. The objective was to estimate the population-level impact of emicizumab on clinical and economic outcomes since its approval and to project the impact over the next 10 years.Methods: A population impact model estimated outcomes associated with emicizumab market approval and uptake compared with a hypothetical scenario in which emicizumab is unavailable. The model evaluated people with moderate or severe hemophilia A (with or without inhibitors) during two time periods: 2016 to 2025 and 2026 to 2035. Outcomes included the number of treated bleeds averted (including treated joint bleeds), the number of arthroplasties prevented, and the total estimated direct healthcare costs and indirect productivity costs associated with these avoided outcomes. Market share values were assumed to remain constant, with no additional therapies entering the market over the next ten years (2026– 2035), when evaluating outcomes for both scenarios.Results: Among an estimated 15,107 people in the US with moderate or severe hemophilia A in 2016, use of emicizumab has resulted in an estimated cumulative total of 958,810 treated bleeds averted (including 699,931 treated joint bleeds) and 2002 arthroplasties prevented since its approval. These avoided outcomes were associated with an estimated $42.6B in direct and indirect costs to payers. Over the next ten years, emicizumab treatment was projected to result in an additional 1.9M treated bleeds averted (including 1.4M treated joint bleeds) and 3292 arthroplasties prevented, with an estimated $80.5B in associated costs.Conclusion: In this US population impact model, emicizumab significantly reduced both bleeding events and the economic burden of hemophilia A.Plain Language Summary: Hemophilia A is a disease where the body cannot stop bleeding properly because an important protein is missing from the blood. These bleeds can happen in joints and lead to damage and pain over time. When people with hemophilia have bleeds, they need emergency treatment and might stay in the hospital.Emicizumab is a treatment for hemophilia A that helps people with the disease bleed less. We built a model of people in the US living with hemophilia A to see how many bleeds and hospital stays were avoided by using emicizumab. We also looked at how much money was saved by avoiding bleeds and hospital stays, and the impact of missing work or school.In the last 10 years, emicizumab has helped to stop nearly 1 million bleeds, which would have cost over $40 billion. When we looked at the next 10 years, emicizumab helped to stop even more bleeds and avoid even more healthcare costs.Keywords: economic models, emicizumab, health care costs, hemophilia A, treatment outcome
Ali Barka Mahamat,1 Mahamat Hassan Abdel-Aziz,1 Abdoulaye Brahim Bechir,1 Bayangbe Emmanuel Djakmoudwé,1 Hamit Mahamat Alio21Department of Biomedical and Pharmaceutical Sciences, National Higher Institute of Sciences and Technology of Abéché (INSSTA), Abéché, Chad; 2Department of Medical Parasitology and Mycology, Faculty of Human Health Sciences, University of N’Djamena, N’Djamena, ChadCorrespondence: Mahamat Hassan Abdel-Aziz, Email mahamathassanabdelaziz2@gmail.comIntroduction: Blood transfusion safety remains a challenge in resource-limited settings. This study estimated the prevalence of reactive screening markers for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis among blood donors at Sarh Provincial Hospital, Chad.Methods: This retrospective cross-sectional study used blood bank register data from 18 September to 18 November 2023. Of 2,868 records identified, 27 were excluded and 2,841 donors were analyzed. Screening used rapid diagnostic tests; confirmatory testing was unavailable. Prevalence estimates and 95% confidence intervals (CIs) were calculated.Results: Participants included 2,173 men (76.49%) and 668 women (23.51%); 97.75% were family/replacement donors. Reactive markers were HBV 275/2,841 (9.68%; 95% CI 8.64– 10.83), syphilis 177/2,841 (6.23%; 95% CI 5.39– 7.18), HCV 104/2,841 (3.66%; 95% CI 3.03– 4.42), and HIV 95/2,841 (3.34%; 95% CI 2.74– 4.07). Overall, 584 donors (20.56%) had at least one reactive marker, and 64 (2.25%) had multiple-marker reactivity. No significant sex differences were observed; age trends were not significant for HBV or HCV.Conclusion: HBV and syphilis were the most frequent reactive screening markers. Because confirmatory testing was not available, results represent screening-marker reactivity rather than laboratory-confirmed infection. Findings are limited to this hospital and the two-month study period. Strengthening voluntary non-remunerated donation, quality assurance, confirmatory testing, and surveillance may improve blood safety.Keywords: reactive screening marker, HIV, HBV, HCV, syphilis, blood donors, Sarh Provincial Hospital, Chad
Thidawan Maikula,1 Piangrawee Niprapan,1 Maitree Sriwichai,2 Sirichai Srichairatanakool,1 Teerachat Punnachet,1 Nonthakorn Hantrakun,1 Pokpong Piriyakhuntorn,1 Thanawat Rattanathammethee,1 Ekarat Rattarittamrong,1 Sasinee Hantrakool11Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Blood Bank Section, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandCorrespondence: Sasinee Hantrakool, Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, Tel +66 81 324 3280, Email sasinee.h@cmu.ac.thPurpose: Iron depletion is increasingly recognized among repeat plateletpheresis donors despite the return of red blood cells during apheresis. However, data on iron status and factors associated with reduced iron stores in plateletpheresis donors in Thailand remain limited. This study aimed to determine the prevalence of iron depletion and identify factors associated with lower iron stores among repeat plateletpheresis donors.Patients and Methods: This cross-sectional study included healthy, non-anemic male repeat plateletpheresis donors at a university hospital blood bank in Thailand. Donors were categorized into three groups according to serum ferritin levels: iron depletion (≤ 30 μg/L), intermediate iron stores (31– 100 μg/L), and higher iron stores (> 100 μg/L). Demographic characteristics, donation history, hematologic parameters, and iron indices were evaluated. Factors associated with iron depletion were explored using univariable logistic regression, whereas factors associated with ferritin ≤ 100 μg/L were evaluated using univariable and multivariable logistic regression.Results: Among 150 participants, iron depletion was identified in 6 donors (4.0%; 95% CI, 1.5– 8.5%), 42 had intermediate iron stores (28.0%; 95% CI, 21.0– 35.9%), and 102 donors had ferritin > 100 μg/L (68.0%; 95% CI, 59.9– 75.4%). Platelet donation frequency, platelet donation volume during the preceding year, lifetime platelet donations, and recent whole blood donation were not significantly associated with either ferritin threshold. In multivariable analysis, body weight (adjusted OR, 0.963; 95% CI, 0.929– 0.998; p=0.036) and reticulocyte count (OR, 0.205; 95% CI, 0.066– 0.637; p=0.006) were independently associated with ferritin ≤ 100 μg/L.Conclusion: Iron depletion was uncommon, but one-third of non-anemic repeat plateletpheresis donors had ferritin ≤ 100 μg/L. Lower body weight and lower reticulocyte count were associated with this ferritin threshold in exploratory analyses. Prospective studies are required to confirm these findings before targeted iron-status screening strategies can be recommended.Keywords: iron depletion, plateletpheresis, donor safety, ferritin, blood donation
Precious Thereza Namazzi,1 Abudu Rahuman Ssekabira,1,2 Ethel Turyasingura Snr,1 Jacintah Nyesigye,1 Edsone Ssemujju,1 Emmanuel Ikaara,1 Gladys Nakidde11Department of Nursing, School of Health Sciences, Soroti University, Soroti, Uganda; 2Department of Nursing, Ngora Hospital School of Nursing and Midwifery, Ngora, UgandaCorrespondence: Abudu Rahuman Ssekabira, Department of Nursing, School of Health Sciences, Soroti University, P.O. Box 211, Soroti, Uganda, Tel +256 777 347 339, Email abudurahumanssekabira@gmail.comBackground: Sickle cell disease (SCD) is a major global health challenge, with over 75% of the burden concentrated in sub-Saharan Africa. Premarital sickle cell trait testing (SCTT) enables informed reproductive decisions that can help carriers reduce the risk of having children with SCD, yet uptake remains poorly documented among young adults in the region.Objective: To assess knowledge and practices towards premarital SCTT among young adults aged 18– 35 years attending the outpatient department (OPD) of a regional referral hospital in Eastern Uganda.Methods: A descriptive cross-sectional study was conducted among 298 young adults attending the OPD at Soroti Regional Referral Hospital (SRRH), selected using simple random sampling. Data were collected via pretested, self-administered questionnaires and analyzed in SPSS version 27 using descriptive statistics and exploratory subgroup comparisons.Results: Of 298 participants, 64.1% were female, with a median age of 28 years (range 18– 35). Awareness of SCD was high (95.3%); 93.0% knew it is inherited and 78.2% knew it is incurable. Most (79.2%) had heard of SCTT, mainly through hospitals (63.6%) and radio (36.9%), but only 12.1% had ever been tested, and 61.1% did not know premarital testing could inform couples of their risk of having a child with SCD. Half (50.0%) had avoided SCTT, citing lack of access (59.1%) and fear of positive results (31.5%) as leading reasons; positive SCTT practice remained low across subgroups, slightly higher among those fearing relationship termination (1.3%).Conclusion: Young adults attending OPD at SRRH showed moderate awareness of SCTT but low uptake. Although most understood that SCD is inherited and incurable, many lacked knowledge of the risk-informing role of premarital testing. Barriers including limited access, fear of positive results, and relationship concerns contributed to low uptake, revealing a knowledge–practice gap that calls for targeted interventions in Eastern Uganda.Keywords: sickle cell trait, premarital testing, knowledge, practices, young adults, Uganda, Soroti
