Sickle cell disease is an inherited genetic disorder that predominantly affects the Black population and can lead to serious complications like stroke and acute chest syndrome, significantly compromising the quality of life of those affected. An integrative literature review was conducted to explore the impact of racial discrimination experienced by patients with sickle cell disease and its influence on the clinical management of the condition. Eleven articles were identified that discussed how the Black population, which often faces vulnerable socioeconomic situations, receives less favorable clinical prognoses given these inequalities. This review emphasizes that institutional racism and racial bias not only lead to higher rates of depression in patients but also influence how healthcare professionals understand and address the disease. This article also examines the relationship between racial discrimination and patient experiences with sickle cell disease, emphasizing the need for more equitable treatment options and for implementing policies that address racial inequalities in healthcare. Additionally, it underscores the importance of social movements in raising awareness of sickle cell disease and influencing health policies.
OBJECTIVE:This study aimed to characterize adult T-cell leukemia/lymphoma (ATLL) cases in Brazil, a human T-cell lymphotropic virus type 1 (HTLV-1) endemic country, focusing on clinical presentation, diagnostic patterns, and prognostic factors, in order to address potential underdiagnosis and improve disease recognition and management. METHODS:A retrospective observational study was conducted at the University of São Paulo reviewing medical records of patients diagnosed with ATLL between 1994 and 2022. RESULTS:Fifty-five patients were included in this study: 29 (52.7%) had indolent ATLL (smoldering/chronic), seven (12.7%) had the lymphoma subtype, and 19 (34.5%) had the acute form. Among the indolent cases, 19 were previously identified as asymptomatic HTLV-1 carriers. HTLV-1 infection was only discovered at ATLL diagnosis in 56% of patients, including 77% among those with aggressive forms. Among known carriers, the median time from HTLV-1 diagnosis to ATLL onset was 9.9 years. Fourteen patients with indolent disease progressed to aggressive ATLL, with a median time of two years and median survival of 55 days after progression. Median overall survival varied by subtype: 68 months (smoldering), 41 (chronic), 13 (lymphoma), and 12.5 (acute). Among 36 patients treated with chemotherapy for aggressive disease, only 22% responded. Cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone was the most common regimen. Only four patients underwent allogeneic stem cell transplantation; one remains alive at seven years. CONCLUSION:Adult T-cell leukemia/lymphoma remains underdiagnosed and poorly characterized in Brazil. Many patients present with or progress to aggressive disease with poor outcomes. These findings underscore the need for improved human T-cell lymphotropic virus type 1 screening, earlier diagnosis, and preventive strategies to reduce disease burden.
Introduction Daratumumab, an Anti-CD38 monoclonal antibody, is now widely used in frontline induction for transplant-eligible multiple myeloma. Although highly effective, concerns remain regarding its potential impact on CD34⁺ stem cell mobilization and early outcomes after autologous hematopoietic stem cell transplantation, particularly when combined with lenalidomide. This study aims to evaluate whether prior daratumumab exposure affects CD34⁺ mobilization, stem cell collection, engraftment, or early post-autologous hematopoietic stem cell transplantation complications. Methods a retrospective, single-center cohort study was conducted in 100 adults who underwent autologous hematopoietic stem cell transplantation. Data on mobilization, CD34⁺ counts, plerixafor use, collection yield, engraftment, infectious complications, engraftment syndrome, intensive care unit admission, and hospitalization were extracted from medical records. Results Of the 100 patients, 46% had received daratumumab therapy. Baseline characteristics were similar except for more frequent prior lenalidomide use in controls (78% versus 35%; p < 0.001). No mobilization failures occurred. Peripheral CD34⁺ levels during mobilization (15 versus 19 cells/µL; p = 0.220) were comparable. Plerixafor use (26% versus 24%; p = 1.0), final CD34⁺ yield (3.80 versus 4.07×10⁶ cells/kg; p = 0.358), and time to neutrophil engraftment (10 versus 10.5 days; p = 0.539) were statistically equivalent. Rates of engraftment syndrome (25%), febrile neutropenia (89%), bacteremia (23%), intensive care unit admission (12%), and hospitalization metrics did not differ significantly. One death occurred in the control group. Conclusion In this real-world cohort, no significant differences in CD34⁺ mobilization, apheresis outcomes, engraftment, or early post-autologous hematopoietic stem cell transplantation complications were observed based on prior daratumumab exposure. These findings support the safety and feasibility of autologous hematopoietic stem cell transplantation following anti-CD38-based induction regimens, including those incorporating lenalidomide.
BACKGROUND:Hepatitis B virus reactivation is a serious complication of allogeneic hematopoietic cell transplantation, particularly in endemic regions. Patients with HBsAg-negative/anti-HBc-positive serology represent an intermediate-risk group due to occult hepatitis B virus infection. This study evaluated hepatitis B virus reactivation risk in haploidentical versus matched donor hematopoietic cell transplantation and assessed the effectiveness of Taiwan's universal prophylaxis policy. METHODS:A retrospective cohort study of 165 adult hematopoietic cell transplantation recipients with HBsAg-negative/anti-HBc-positive status was conducted at China Medical University Hospital, Taiwan from 2010-2025. The incidence of hepatitis B virus reactivation was compared between the pre-prophylaxis (2010-February 2021) and post-policy implementation (March 2021-2025) periods. Univariable associations, clinical outcomes, and temporal patterns were analyzed. RESULTS:Pre-prophylaxis, haploidentical recipients had higher reactivation rates (11.2%vs. 2.9%), but this did not reach statistical significance due to the small number of events (Odds ratio: 4.31; 95% CI: 0.67-37.55; p = 0.279). In the univariable analyses, hepatitis B virus reactivation was associated with chronic graft-versus-host disease (p = 0.001) and donor anti-HBs negativity (p = 0.001), with a median time to reactivation of 8.2 months. CONCLUSION:In this cohort, haploidentical hematopoietic cell transplantation with post-transplant cyclophosphamide was associated with a higher observed rate of hepatitis B virus reactivation than matched donor transplantation in HBsAg-negative/anti-HBc-positive recipients, although this difference was not statistically significant.
OBJECTIVE:This study aimed to evaluate the effect of red blood cell processing on the hemoglobin increment in oncology patients requiring packed red blood cell transfusions. MATERIAL AND METHODS:The study population in this prospective, open-label, randomized controlled trial included healthy blood donors and oncology patients. Only first-time male donors aged 18 to 30 years with hemoglobin levels between 12.5 and 15 g/dL who were donating whole blood were included. Whole blood was collected in 450 mL triple or quintuple blood bag systems with integral leukoreduction filters. The triple bags were processed using the platelet-rich plasma method (non-Saline-Adenine-Glucose-Mannitol), whereas the quintuple bags were processed via the buffy coat method and leukoreduced using inline leukofilters (leukoreduced Saline-Adenine-Glucose-Mannitol). Enrolled patients were randomly allocated to two groups: Group I received non- Saline-Adenine-Glucose-Mannitol packed red blood units, and Group II received leukoreduced Saline-Adenine-Glucose-Mannitol packed red blood units. RESULTS:Group II had red blood cell volume loss of 33.81 ± 3.49 mL during processing (p-value < 0.001). The calculated total hemoglobin content was significantly higher in Group I (67.75 ± 3.18 versus 62.47 ± 3.62 g/unit; p value < 0.001). No significant difference was observed between actual total hemoglobin content of Group I and Group II (47.51 ± 2.02 versus 46.44 ± 5.66 g/unit, p = 0.119). No significant difference was observed in the mean hemoglobin increment (Group I: 1.85 ± 0.91 g/dL versus Group II: 1.83 ± 0.64 g/dL, p = 0.887). CONCLUSION:Loss of hemoglobin during processing did not affect the hemoglobin increment in oncology patients in our study.
Extracorporeal photopheresis is a unique immunomodulatory therapy that involves the ex vivo treatment of leukocytes with 8-methoxypsoralen and ultraviolet A light, followed by reinfusion into the patient. Initially developed for cutaneous T-cell lymphoma, extracorporeal photopheresis has gained recognition for its efficacy in treating various immune-mediated conditions such as graft-versus-host disease, systemic sclerosis, solid organ transplant rejection, and inflammatory bowel diseases. This review outlines the historical evolution, pharmacology of psoralens, mechanisms of action, clinical applications, equipment types, quality control methods and practical aspects for initiating extracorporeal photopheresis. The therapy's core mechanism, inducing apoptosis and modulating dendritic cell function, promotes immune tolerance and regulatory T-cell expansion. Different inline and offline systems are employed, each with distinct operational and safety considerations. Current evidence supports extracorporeal photopheresis in steroid-refractory graft-versus-host disease and cutaneous T-cell lymphoma, although its role in visceral and long-term disease remains underexplored. Quality control methods such as proliferation assays, flow cytometry, and surrogate markers are discussed in detail. Despite its promise, further randomized trials are necessary to clarify standardized protocols and long-term outcomes.
Introduction Hematopoietic stem cell transplantation is an effective treatment for hematological diseases but it is frequently associated with oral complications such as hyposalivation and xerostomia, particularly in cases of chronic Graft-versus-Host Disease. The objective of this study was to evaluate unstimulated salivary flow in patients who underwent transplantations at least five years previously and to investigate possible associations between hyposalivation and systemic and oral chronic Graft-versus-Host Disease. Methods This retrospective cross-sectional study included 27 patients treated at the National Cancer Institute of Brazil (INCA), with a minimum of five years post-allogeneic transplantation. Clinical data were obtained from medical records. Unstimulated saliva was collected following the protocol described by Davies et al., and salivary flow was classified according to Flink et al. Statistical analysis was performed using SPSS version 18.0 software. Results Most patients presented sialometry within normal limits (63.0%), with a median of 0.5 mL/min. Xerostomia was reported by 33.3% of participants. The prevalence of systemic chronic Graft-versus-Host Disease was 81.5%, while that of oral chronic Graft-versus-Host Disease was 63.0%. No statistically significant associations were observed between hyposalivation and systemic or oral chronic Graft-versus-Host Disease. Conclusion Although most patients maintain adequate salivary function five years after the transplantation, xerostomia remains a clinically relevant symptom. The absence of statistical association with chronic Graft-versus-Host Disease suggests the need for further studies to explore other contributing factors.
INTRODUCTION:Chronic lymphocytic leukemia shows significant clinical heterogeneity, highlighting the need for reliable, accessible biomarkers for staging and prognosis, especially in resource-limited settings. This study evaluates the association between inflammatory and nutritional biomarkers and clinical stage in newly diagnosed, treatment-naïve patients. METHODS:A cross-sectional study enrolled 150 treatment-naïve chronic lymphocytic leukemia patients and 150 matched healthy controls at outpatient hematology clinics affiliated with Isfahan University of Medical Sciences (2024-2025). Diagnoses followed International Workshop on chronic lymphocytic leukemia 2018 criteria. Controls were confirmed healthy by peripheral blood counts, smear evaluation, and clinical examination. The Rai staging system was used. Serum biomarkers were measured at diagnosis. Statistical analysis included Analysis of Variance and Kruskal-Wallis tests, and Spearman correlation. RESULTS:Elevated ferritin, β2-microglobulin, lactate dehydrogenase and C-reactive protein levels, erythrocyte sedimentation rate, and C-reactive protein-to-albumin ratio correlated significantly with advanced Rai stages (III-IV) (p-value <0.05) reflecting greater tumor burden and systemic inflammation. Conversely, albumin and vitamin D3 levels declined with disease severity. Ferritin and β2-microglobulin showed the strongest correlations with clinical stages, reinforcing their prognostic value. CONCLUSION:Routine biomarkers such as ferritin, β2-microglobulin, lactate dehydrogenase, C-reactive protein-to-albumin ratio, and vitamin D3 are strongly associated with clinical stage and disease severity in treatment-naïve chronic lymphocytic leukemia patients. Their measurement provides cost-effective, accessible prognostic tools, especially where advanced molecular testing is unavailable. Incorporating these biomarkers into clinical staging may improve early risk stratification and guide management.
OBJECTIVE:Hemoglobin (Hb) variants and thalassemia interactions create complex syndromes, complicating diagnosis. This study aimed to characterize the molecular basis, genetic profile, and potential hematological features of a rare α-hemoglobin variant. METHODS:A 44-year-old Thai male presented with unspecified chronic anemia with hepatosplenomegaly. Hematological data were obtained using a standard automated cell counter. Hemoglobin analysis was performed using high-performance liquid chromatography and capillary electrophoresis. Mutational and globin haplotypes were analyzed using polymerase chain reaction and sequencing. The pathogenicity of the mutant gene was predicted, and novel diagnostic methods based on allele-specific polymerase chain reaction were developed. RESULTS:Hematological analysis revealed the following: red blood cell count, 1.74 × 10¹²/L; hemoglobin, 3.7 g/dL; hematocrit, 17%; mean corpuscular volume, 84.7 fL; mean corpuscular hemoglobin, 21.3 pg; mean corpuscular hemoglobin concentration, 25.1 g/dL; and red cell distribution width, 40.5%. Further, Hb A2ABart's with abnormal peaks migrated faster than Hb A. DNA sequencing identified a missense mutation at codon 10 (GTC>GAC), causing a valine-to-aspartic acid substitution responsible for Hb Chumphae. Additionally, an α0-thalassemia (SEA deletion) was identified. Predictions and classifications of pathogenicity indicated a pathogenic effect. Polymerase chain reaction-restriction fragment length polymorphisms and allele-specific polymerase chain reaction assays successfully identified this mutation. An α-haplotypic [- - M - - - -] was possibly associated with Hb Chumphae. CONCLUSIONS:The presence of Hb Chumphae in combination with α0-thalassemia as a compound heterozygote leads to severe anemia worse than hemoglobin H disease. The diagnosis of Hb Chumphae is challenging as high-performance liquid chromatography and capillary electrophoresis chromatograms mimic those of Hb Bart's. Accurate diagnosis requires globin genotyping.
BACKGROUND:Febrile neutropenia, a frequent complication in patients undergoing autologous stem cell transplantation, increases morbidity and hospitalization costs. OBJECTIVE:The aim of this study was to compare the efficacy of two formulations of pegylated filgrastim with filgrastim in patients who received autologous stem cell transplantation as outpatients for lymphoma or myeloma. METHODS:Thirty patients were randomized to receive a single 6 mg dose of either reference or biosimilar pegfilgrastim on Day +1. A retrospective Control Group of fifty-three patients who received filgrastim was included. MAIN RESULTS:The median times to neutrophil engraftment were 10, 9 and 11 days for the innovator pegfilgrastim, biosimilar pegfilgrastim (p-value = 0.14), and filgrastim (p-value = 0.0001), respectively. The median times to platelet engraftment were 10 days for both of the pegfilgrastim groups and 12 days for the filgrastim group (p-value = 0.0001). Febrile neutropenia incidence was lower in the pegfilgrastim group (6.7%) than in the filgrastim group (24.5%; p-value = 0.04). Cost analysis showed higher costs for the innovator pegfilgrastim, with filgrastim having the lowest cost of the three formulations. CONCLUSION:The innovator and the biosimilar pegfilgrastim demonstrated similar efficacy in engraftment speed and febrile neutropenia incidence. Pegfilgrastim was associated with faster engraftment, a lower incidence of platelet transfusion, and a lower incidence of febrile neutropenia.
Introduction Treatment resistance has become increasingly common in patients with chronic myeloid leukemia. Lack of response to tyrosine kinase inhibitors is associated with mutations in the BCR::ABL1 kinase domain. This study aims to report the frequency and types of BCR::ABL1 kinase domain mutations in Pakistani chronic myeloid leukemia patients. Materials and methods This prospective study was conducted from January to June 2025 at the Armed Forces Institute of Pathology in Pakistan. It included adult patients with chronic myeloid leukemia who were non-responsive to treatment based on molecular, hematological, and clinical criteria. Allele-specific real-time polymerase chain reaction was performed to detect four kinase domain mutations: T315I, E255V, E255K and Y253H. Data was analyzed using IBM SPSS v23. Results The mean age of the 133 treatment-resistant chronic myeloid leukemia patients included in the study was 47.3 ± 13.6 years. The majority of cases (62.4%) were male and 79 (59.4%) patients were currently on imatinib therapy. The median BCR::ABL1 level, as measured by quantitative polymerase chain reaction, was 30.73% (range: 1.17–100%) International Scale. BCR::ABL1 kinase domain mutations were detected in 57 (42.9%) patients. E255K was the most common mutation detected in 45 (33.8%) cases, followed by E255V in 11 (8.3%), T315I in 1 (0.8%) and the Y253H mutation in 1 (0.8%) patient. The presence of kinase domain mutations was significantly associated with higher total leucocyte count (p = 0.002), while the E255K mutation was significantly associated with blast crisis (p = 0.048). Conclusion This study revealed a high prevalence of BCR::ABL1 kinase domain mutations in Pakistani chronic myeloid leukemia patients. E255K, the most frequently detected mutation, was significantly associated with blast crisis. These findings underscore the significance of molecular testing for personalized treatment.
BACKGROUND:Hematopoietic stem cell transplantation is the sole therapeutic approach that can provide a complete cure for thalassemia. However, this procedure is associated with complications that may have life-threatening consequences. To date, long-term survival outcomes after transplantation in thalassemia have not been systematically synthesized. This study aims to specifically evaluate long-term overall survival in patients with thalassemia undergoing hematopoietic stem cell transplantation. METHODS:A comprehensive search was conducted across multiple databases, including PubMed, CENTRAL, Europe PMC (incorporating medRxiv and bioRxiv), EBSCOHost (Medline), and ProQuest. The search spanned from the inception of each database through July 10, 2024, using a combination of predefined keywords: 'Hematopoietic Stem Cell Transplantation', 'Thalassemia', 'Survival Rates', and synonyms. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. Heterogeneity was evaluated via I2 statistics, while pooled effect estimates were calculated using the DerSimonian-Laird inverse-variance random-effects model. Statistical significance was defined as p < 0.05. Additionally, a leave-one-out sensitivity analysis was performed to ensure the robustness of the findings. RESULTS:Out of an initial 690 records identified, four articles involving a total of 616 transplanted thalassemia patients were included in this study. The survival rates were 86.8% (95% CI: 80.1%- 92.3%) in 15 years, 89.2% (95% CI: 82.2%-96.2%) in 20 years, 82.6% (95% CI: 79.9%-85.3%) in 30 years, and 81.4% (95% CI: 74.5%-88.9%) in 39 years. The pooled survival rate was 85% (95% CI: 81%-89%; I2 = 40%). The pooled survival rate showed no significant differences in leave-one-out sensitivity analysis. CONCLUSION:The present meta-analysis shows relatively high long-term overall survival rates in patients with thalassemia after hematopoietic stem cell transplantation. Nonetheless, the relatively small patient population, heterogeneity in anti-thymocyte globulin implementation, and potential confounding risks intrinsic to the study necessitate cautious interpretation of the findings.
INTRODUCTION:The Rh blood group system is recognized for its complexity and its clinical importance in transfusion medicine. Antibodies against Rh antigens are associated with hemolytic transfusion reactions, autoimmune hemolytic anemia, and hemolytic disease of the fetus and newborn. The present study aims to characterize D antigens and assess their allele frequencies at the molecular level. METHODS:Molecular characterization of RHD variants was performed on blood donors from the Brazilian Central-West who presented atypical D typing results. Serological profiles of all identified RHD variant alleles were also analyzed using different anti-D clones. RESULTS:Among the D-positive samples, 1.25% exhibited weak or discrepant agglutination during serological D typing. Most samples (67/103; 65%) were classified within the RHD*weak partial 4 cluster, followed by RHD*weak D type 3 (17/103; 16%). Lower frequencies were observed for RHD*weak D type 1 (2/103; 1.9%) and RHD*weak D type 2 (6/103; 5.8%). Furthermore, the rare RHD*weak D type 38 and RHD*weak D type 145 variants were identified. Analysis with different anti-D reagents showed that 52% of the samples had agglutination scores below 2+. Notably, 27% were classified as inconclusive, and 21% exhibited RhD serological discrepancies. CONCLUSION:Atypical reactions in RhD serological testing indicate the presence of variant D antigens. The RHD*weak partial 4 allele was the most prevalent RHD variant in the Brazilian Central-West population. However, the identification of rare RHD*weak D variants, such as types 38 and 145, highlight the genetic diversity reflective of the region's multiracial composition. Understanding the distribution of RHD variants can improve transfusion support and inform future RHD genotyping strategies.
Introduction Although the clinical benefits of patient blood management are internationally recognized, data regarding its implementation in Brazilian cardiovascular surgery remain limited. This study evaluated knowledge on patient blood management, reported practices, and perceived barriers among Brazilian cardiovascular surgeons. Methods This cross-sectional survey was conducted among 1,105 cardiovascular surgeons registered with the Brazilian Society of Cardiovascular Surgery. A 30-item questionnaire assessing professional characteristics, preoperative anemia management, perioperative transfusion practices, and patient blood management adoption was distributed via email. Descriptive and inferential statistical analyses were performed. Results The response rate was 19.4% (n = 205). Most respondents were male (91%) and based in the southeastern region. Preoperative anemia screening and management were heterogeneous. Thirty-one percent estimated the prevalence of preoperative anemia at 5%–15% in their institutions, and 43% reported hemoglobin testing 1–2 days before surgery. Approximately 25% routinely calculated erythrocyte mass and blood volume. Institutional transfusion risk protocols were reported by 48% of respondents, and 62% indicated standardized blood component request parameters. Antifibrinolytics and hemostatic agents were the most frequently reported coagulation strategies. Interest in patient blood management implementation was reported by 52%; perceived barriers included cultural resistance (43%), financial constraints (24%), and administrative challenges (21%). A statistically significant association was observed between geographic region and reported interest in patient blood management implementation. Conclusion Patient blood management implementation was reported as heterogeneous across institutions. Respondents identified cultural, economic, and structural barriers to patient blood management implementation. These findings reflect surgeons’ self-reported perceptions and should be interpreted within the limitations of a cross-sectional survey with limited regional representativeness.
BACKGROUND:Iron deficiency anemia remains a major global health concern, especially among women, children, and people with chronic illnesses. Oral iron therapy is the standard treatment, but it is often limited by gastrointestinal side effects or poor absorption. Intravenous ferric derisomaltose is a newer formulation that allows high-dose, rapid iron replenishment with a favorable safety profile. This study aimed to assess the effectiveness and safety of intravenous ferric derisomaltose in patients with iron deficiency anemia who could not tolerate or did not respond to oral iron. METHODS:This was a prospective, open-label, single-center trial conducted in São Paulo, Brazil. Adult patients (≥18 years) with iron deficiency anemia received 1 or 2 infusions of intravenous ferric derisomaltose (up to 1000 mg per infusion). Hematologic and iron parameters were measured at baseline, Week 4, and Week 8. Safety outcomes included adverse events and serum phosphate levels. RESULTS:Thirty patients were treated with 25 requiring a second infusion. Significant increases in hemoglobin, serum ferritin, transferrin saturation, and reticulocyte hemoglobin content were seen at both time points. By Week 8, 81% achieved a hemoglobin increase ≥2 g/dL, and 54% achieved an increase of ≥3 g/dL. Four (8%) mild adverse events occurred and three patients (10%) experienced transient, asymptomatic hypophosphatemia, which resolved without intervention. CONCLUSION:This study contributes to the growing evidence supporting the use of intravenous ferric derisomaltose as a safe and effective alternative for distinct populations with iron deficiency anemia. In this real-world clinical setting, the treatment is effective for treating patients with iron deficiency, providing rapid hematologic recovery with a favorable safety profile.
Background and Objectives: False-positive serological results in blood donation screening may arise from antibody cross-reactivity, limitations in assay specificity, or low-level reactivity during early-stage infections, ultimately leading to donor deferral and the discard of viable blood units. This study evaluated the prevalence, time trends, and demographic factors associated with false-positive serologic screening results for transfusion-transmissible infections in a Brazilian blood center. Materials and Methods: A cross-sectional study was conducted including all blood donations collected between 2013 and 2022 at a private blood center in São Paulo, Brazil. Donations were screened with serologic tests for syphilis, human immunodeficiency virus, hepatitis B virus, and hepatitis C virus. Reactive samples underwent confirmatory testing, where a false-positive result was defined as an initially reactive screening assay followed by a nonreactive confirmatory test. Associations between demographic variables and false-positive or true-positive results compared to true negative results were analyzed using multivariable Poisson regression. Results: A total of 129,166 donors were included. Most donors (98.7%) had nonreactive results for all serologic tests. Reactive screening results were observed in 0.5% of donations for both syphilis and hepatitis B virus, 0.2% for hepatitis C virus, and 0.1% for human immunodeficiency virus. False positivity occurred more frequently for human immunodeficiency virus (92.0%) and hepatitis C virus (72.7%). Older age, lower education levels, and first-time donation were associated with false-positive results, whereas male sex, non-white race/skin color, lower education levels, and being single or divorced were associated with true-positive status. Conclusion: False-positive results were more frequent among first-time and less-educated donors. This study found no consistent overlap between demographic factors associated with false positivity and true positivity. This suggests that false positivity mainly occurs by chance or from antibody cross-reactivity.
