BACKGROUND:Limited data exists on detailed cellular content of infused autografts and correlations between autograft cellular components according to plerixafor (PLER) use in the mobilization of blood grafts. STUDY DESIGN AND METHODS:The present study compared cellular content of infused autografts analyzed by flow-cytometry, correlations between various graft cellular components and post-transplant outcome of 159 patients with systemic NHL mobilized with or without on-demand plerixafor. RESULTS:In PLER mobilized patients (n = 42) the total number of graft CD3+ cells was 2.5-fold higher (p < 0.001) and the number of both CD3+CD8+ cells (p < 0.001) and NK cells (p < 0.001) were almost 3-fold higher compared to non-PLER patients (n = 117). In addition, graft CD3+ cell counts correlated with graft NK cell counts (rs 0.622, p < 0.001) only in non-PLER group. Moreover, graft CD34+ cell counts did not correlate with any lymphocyte subtypes of the grafts. Most importantly, PLER use in the mobilization had no impact on progression-free survival or overall survival of the patients. DISCUSSION:PLER use impacts significantly on graft cellular composition and correlations between various cellular components without compromising outcome in the patients. Engineering the autograft content by analyzing CD3+ cell counts and its main components in the grafts during collection might be important.
Periorbital purpura ("raccoon eyes") is a rare but characteristic clinical finding associated with systemic amyloidosis and plasma cell disorders. It results from increased vascular fragility due to amyloid deposition within vessel walls and may serve as an important diagnostic clue for underlying hematological diseases. We report a 60-year-old woman presenting with recurrent, non-traumatic periorbital purpura as the sole clinical manifestation. Evaluation for an underlying plasma cell disorder revealed elevated serum free lambda light chains and an abnormal kappa/lambda ratio. Serum immunofixation electrophoresis demonstrated an IgA lambda monoclonal gammopathy. Bone marrow evaluation showed borderline plasma cell infiltration (10-12%) with lambda-restricted clonal plasma cells, and Congo red staining confirmed amyloid deposition. The patient had a low serum M-protein level and no CRAB features, lytic bone lesions, or other myeloma-defining events. Therefore, the case was classified as AL amyloidosis associated with a low-burden clonal plasma cell neoplasm. This case highlights that AL amyloidosis may arise from low-tumor-burden plasma cell clones without overt multiple myeloma features and that raccoon eyes may occasionally represent the only presenting sign, allowing early recognition of the underlying plasma cell disorder.
BACKGROUND AND AIMS:The complex history of genetic admixture in Latin American populations creates unique erythrocyte antigen profiles. This study aimed to determine the extended red blood cell (RBC) antigen frequencies in a blood donor population from Southwestern Colombia, a region with significant African ancestral heritage, to support phenotype-matched transfusion strategies and optimize donor selection. MATERIALS AND METHODS:A cross-sectional study was conducted on 501 voluntary blood donors at a highly complex hospital blood bank in Cali, Colombia. Extended serological phenotyping for the Rh, Kell, Kidd, Duffy, MNS, Lutheran, Lewis, and P blood group systems was performed using automated gel card assays. Antigen and phenotype frequencies were determined, and low-frequency profiles relevant to transfusion compatibility were identified. RESULTS:The donor cohort (60.3% female, median age 24 years) exhibited substantial antigenic diversity. Key antigen frequencies included D (92.0%), e (95.2%), c (77.8%), C (67.3%), E (62.9%), and a remarkably low prevalence of the K antigen (4.2%). Within the Duffy system, 5.4% of the population expressed the Fy(a-b-) phenotype, confirming the strong demographic influence of African heritage in the region. Operationally important rare phenotypes were successfully identified, including Fy(a-b-) (n = 27), Lu(a+b-) (n = 2), k- (n = 1), and M-N + S-s- (n = 1). CONCLUSION:The distinct antigenic variability observed in Southwestern Colombia underscores the limitations of relying on foreign reference frequencies for local transfusion practices. Developing regional immunohematologic databases and coordinated rare donor registries is essential to optimize extended serologic matching, ensure the timely provision of compatible units, and mitigate alloimmunization risks for chronically transfused patients.
Transfusion medicine is a high-stakes discipline where laboratory professionals play critical roles to ensure safe and appropriate blood product use. Five papers, from Argentina, Australia, Japan, Thailand, and the United States, report how blood bank and transfusion laboratory professionals (hemotherapy technicians, laboratory scientists, medical technologists) are educated, credentialed, and integrated into clinical practice. Common themes include: (1) the need for standardized, accessible foundational education; (2) the evolution of technical roles toward professionalization and leadership; (3) the use of structured curricula, eLearning, experiential learning, and certification systems; and (4) measurable impacts on knowledge, self-efficacy, professional identity, and transfusion safety. Argentina has formalized hemotherapy technician and bachelor-level training, expanding competencies beyond bench work to include management and policy-making. Transfusion Laboratory Essentials, an online course based in Australia, demonstrates high engagement and completion rates among early-career scientists. Japan’s nationally credentialed clinical laboratory technologists and certified transfusion laboratory technologists have improved 24-hour transfusion services and hospital accreditation standards. Experiential learning at Thailand’s National Blood Centre significantly enhances students’ knowledge, self-efficacy, and professionalism. The United States has a tiered certification system (MLT, MLS, BB, SBB) that is currently addressing visibility and staffing challenges. Collectively, these examples illustrate global trends toward professionalization, competency-based education, and team-based transfusion practice, with implications for workforce planning, curriculum design, and quality improvement in transfusion medicine worldwide.
The clinical use of platelet concentrate preparations has evolved within AI-informed, modernized practice, moving from classical formulations toward extracellular vesicle-based and engineered therapies and reflecting a major shift toward regenerative medicine. Although first-generation preparations, particularly platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), remain the most widely used, next-generation products may offer enhanced bioactivity, improved standardization and broader applicability across dental, orthopedic, ocular and wound-healing indications. Among the most promising innovations are engineered platelet subfractions, including cultured platelets, and extracellular vesicle-based formulations, such as exosomes and microparticles. These advances in platelet bioproducts enable enrichment of selected bioactive components and may support scalable production with reduced dependence on donor variability. Exosome-based approaches are especially attractive because they can deliver growth factors, cytokines, lipids and nucleic acids that mediate intercellular signaling and tissue repair. Platelet-mimetic nanoparticles are also emerging as versatile platforms for targeted drug delivery and regenerative intervention. Despite considerable progress, engineered platelet preparations are not yet positioned to replace donor-derived platelets in routine clinical practice. Important barriers remain, including incomplete standardization, challenges in demonstrating bioequivalence, manufacturing complexity and the need for robust translational and regulatory frameworks. Artificial intelligence (AI) may help address several of these limitations by supporting product optimization, quality control, data integration and patient-specific therapeutic selection. In this AI-informed expert narrative review, we examine why safer and more diverse platelet bioproducts are being developed, their clinical relevance and how AI may influence the future interpretation, development and implementation of platelet-based regenerative therapies. We also discuss ongoing innovation in validated blood-derived platelet concentrates and platelet subpopulations for tissue repair, regeneration and related clinical applications from the perspective of transfusion medicine and regenerative medicine experts.
As medical technology advances, laboratory-based medical technologists have gained visibility as essential members of patient-centered healthcare teams. In Japan, this has been especially evident since the end of World War II. Legal and professional frameworks have evolved to train and credential clinical laboratory technologists, not only for ever more complicated laboratory investigations, but also, for active engagement with other healthcare professionals and even with patients themselves. Herein, we introduce some history, followed by current demographics, describe training and certification programs, show outcomes, and consider future directions. Paradigms brought to post-war Japan have been adopted, and adapted, for a national context that can now be adopted and adapted by other countries around the world.
The 2026 Joint Meeting of the American Society for Apheresis (ASFA) and the World Apheresis Association (WAA) convened in Denver, Colorado from April 22-24, representing the 4th occasion on which these two major international apheresis organisations have co-hosted a joint congress. This report summarises the scientific content, educational program, and key themes of the meeting.
From the beginning of the use of blood for therapeutic purposes, technicians in Argentina played an important role. The scope of the hemotherapy technician's activities includes participation in all processes of transfusion medicine. Hemotherapy technicians' workplaces are hemotherapy services in all their complexity. Current training in Argentina considers the hemotherapy technician no longer as an assistant, but as a professional in the health area. The creation of the Bachelor's Degree in Hemotherapy and Immunohematology responds to the need to professionalize human resources in health, raising the academic level of previous technical training. For this reason, the great pending challenge is to assume leadership roles and responsibility for the improvement of the organization and the results of the work of others for the benefit of donors, blood recipient patients and the entire community.
Red blood cell (RBC) alloimmunization in pregnancy remains a major cause of hemolytic disease of the fetus and newborn (HDFN). Multiple maternal alloantibodies are uncommon and present significant diagnostic, and transfusion challenges. We report a case of a 35-year-old gravida, with anti-D, anti-C, anti-Fya, and anti-M alloantibodies detected at 10 weeks gestation. Initial titers of anti-D and anti-C were low and stable under serial monitoring. Non-invasive fetal genotyping confirmed an RHD-positive fetus. Following routine maternal vaccination against influenza (28 weeks), pertussis (30 weeks), and RSV (32 weeks), a rapid rise in anti-D and anti-C titers was observed at 31-32 weeks, accompanied by increased serologic reactivity of anti-Fya and anti-M. Middle cerebral artery peak systolic velocity (MCA-PSV) rose to 1.7 MoM, indicating fetal anemia. Two intrauterine transfusions with antigen-negative RBCs were performed. The patient delivered at 37 weeks. The neonate required phototherapy, IVIG, and transfusion support but had a favorable outcome. The temporal association between vaccination and antibody escalation raised the question of immune modulation. Although molecular mimicry is unlikely, non-specific polyclonal immune activation with bystander stimulation of memory B cells may represent a biologically plausible mechanism. However, causality cannot be established. This case highlights the dynamic nature of multiple maternal alloimmunizations, the critical role of serial monitoring and logistical challenges of providing antigen-negative blood for IUT.
Background Transfusion dependency (TD) is a recognized adverse prognostic marker in myelodysplastic syndromes (MDS), yet its predictors and survival impact remain poorly characterized in Saudi Arabian patients. Aim To identify clinical and hematologic predictors of TD and evaluate its impact on overall survival in a cohort of Saudi MDS patients. Methods This single-center retrospective cohort study included 180 adult MDS patients diagnosed per the WHO 2022 criteria. Multivariable logistic regression identified independent predictors of TD. Kaplan-Meier curves and Cox proportional hazards regression assessed survival outcomes. Mediation and interaction analyses explored TD's role within established risk frameworks. Results Sixty percent of patients were transfusion dependent. Lower hemoglobin (OR = 0.40 per g/dL, p < .001) and poor cytogenetic risk (OR = 6.10, p = .002) were the strongest independent predictors of TD. Transfusion-dependent patients had significantly shorter median survival (38 vs. 51 months, p < .001). After multivariable adjustment, TD remained an independent predictor of mortality (HR = 2.67, p < .001). A significant interaction between TD and IPSS-R category was identified, while mediation analysis indicated TD operates as a parallel rather than mediating pathway. Conclusion TD is an independent, powerful predictor of mortality in MDS, driven primarily by severe anemia and poor cytogenetics. Dynamic monitoring of transfusion status is essential across all risk strata.
