No abstract available.
Chimerism ; Hematopoietic Stem Cells

The Korean Journal of Blood Transfusion (KJBT) stands as a prominent publication in the field of transfusion medicine, playing a pivotal role in advancing both national blood management projects and clinical explorations.In three years (2021∼2023) KJBT has disseminated 60 articles. During this period, five new article types (opinion, illustrated, mini-review, protocol, and annual report) have been introduced, and a new version of the online submission system has been implemented. The articles in KJBT have also been used as a valuable reference source for the first textbook on transfusion medicine published by the Korean Society of Blood Transfusion in 2023. With the ongoing efforts of the editorial team to provide better services to authors and readers, coupled with the sustained interest and passion of all the members, we hope that KJBT will continue to contribute to the advancement of domestic transfusion medicine research and the national blood program.

Coronavirus disease 2019 (COVID-19) emerged in December 2019 in Wuhan, China; it has since caused a pandemic, with more than 10,000 confirmed cases (> 800,000 tests) in Korea as of May 2020. Real-time reverse transcription polymerase chain reaction (RT-PCR) is currently the most commonly used method for the diagnosis of COVID-19 worldwide. The Korean Society for Laboratory Medicine and Korea Centers for Disease Prevention and Control regularly update the guidelines for COVID-19 diagnosis. Emergency use authorization for some laboratory diagnostic kits has been granted, enabling the timely diagnosis and treatment of COVID-19, and the isolation of infected patients. Due to the collective efforts of the government, medical professionals, local authorities, and the public, Korea’s response to the COVID-19 outbreak has been accepted widely as a model. Here, we summarize the currently available laboratory tests for COVID-19 diagnosis. Although RT-PCR tests are used widely to confirm COVID-19, antibody tests could provide information about immune responses to the virus.

The Landsteiner–Wiener (LW) antigen is a type of red blood cell antigen. Anti-LW appears in various situations, including alloantibodies, autoantibodies, and even transiently occurring antibodies. Anti-LW has similar characteristics to anti-D, so it can interfere with interpreting pre-transfusion tests and finding compatible blood. This paper introduces three cases in whom anti-LW was detected through antibody identification tests. All three cases were examined using the column agglutination technique with ID-DiaPanel (Bio-Rad, Hercules, CA, USA) on a LISS/Coombs card, ID-DiaPanel p (Bio-Rad) on a NaCl/Enzyme card, and ID-DiaPanel (Bio-Rad) on a LISS/Coombs card using red blood cells treated with dithiothreitol. The auto-control test, direct antiglobulin test, and umbilical cord blood test were also performed. In all three cases, the reaction with D-positive panel cells was stronger than that with the D-negative panel cells, and two of them showed a pan-agglutinated reaction in ID-DiaPanel p (Bio-Rad) with NaCl/Enzyme card. They were reported as anti-LW, and as in these cases, anti-LW can occur under a range of conditions and interfere with proper transfusion. Therefore, it is important to identify anti-LW accurately, and if anti-LW is present, the transfusion of D-negative ABO matched blood should be recommended because of the low expression of the LW-antigen. On the other hand, D-positive blood is not a contraindication when an urgent transfusion is needed.

We would like to introduce domestic subscribers of the Korean Journal of Blood Transfusion to the important aspects to be considered while selecting a reference allele and reporting a new allele candidate. ABO*A1.02 has only a single nucleotide substitution of c.467C＞T in ABO*A1.01, and when ABO*A1.01 is used as the reference allele, the ABO*AW.10 allele should be marked as having both c.467C＞T and c.784G＞A variants. Unfortunately, it has not been modified as such in the ISBT database. For this reason, in the journal Transfusion (2020), the official journal of the Association for the Advancement of Blood Biotherapies, there was a report of a new allele with c.467C＞T and c.784G＞A variants. Cases of ABO*AW.10 allele with a weak A phenotype are not uncommon in Koreans, and it is necessary to accurately mark the reference allele. The blood type A reference allele of the International Society of Blood Transfusion (ISBT) database currently used for ABO alleles reporting is based on ABO*A1.01. Therefore, it should be considered that the ABO*AW.10 allele has both the c.467C＞T and c.784G＞A variants together.

BACKGROUND: Free light chain (FLC) is widely used to evaluate B-cell proliferative diseases. Herein, we estimated the clinical usefulness of serum FLC in multiple myeloma (MM). METHODS: Fifty-one patients were enrolled. We performed FLC analysis, protein electrophoresis (PEP), and immunofixation electrophoresis (IFE). FLC was measured using Toshiba 200 FR Neo with FREELITE(TM), and kappa/lambda (kappa/lambda) ratio was calculated. We compared these parameters in 41 patients with increased FLC before and after bortezomib treatment. Complete response (CR) was defined as the disappearance of monoclonal (M) protein in serum and/or urine as measured by IFE. Partial response (PR) was defined as > or =50% reduction of serum M protein. Early objective response (EOR) included both CR and PR. Minimal response (MR) was defined as 25-49% reduction of M protein and stable disease (SD) as <25% reduction. RESULTS: Forty-one (80.4%) of the 51 patients studied revealed increment of FLC and the five patients with no increment revealed an abnormal kappa/lambda ratio. Especially, all of the light chain myeloma and non-secretory myeloma showed increased FLC concentrations. Among the patients with EOR, 72.4% (21/29) showed a normal or subnormal FLC concentration after the first cycle of treatment. Otherwise, PEP and IFE normalized in 24.1% (7/29) and 24.1% (7/29), respectively. The ratio of decreased FLC after the first cycle of treatment was significantly different between EOR and other response groups (MR, SD) (90.6% vs 51.8%, P=0.011). CONCLUSIONS: FLC was considered as a good diagnostic method in complement with PEP and IFE in MM, especially in light chain myeloma or non-secretory myeloma. Moreover, FLC is a useful monitoring tool because it reflects therapy results more rapidly owing to a short serum half-life.
Adult ; Aged ; Boronic Acids/therapeutic use ; Female ; Humans ; Immunoelectrophoresis ; Immunoglobulin Light Chains/*blood/urine ; Male ; Middle Aged ; Multiple Myeloma/*diagnosis/therapy ; Pyrazines/therapeutic use ; Reagent Kits, Diagnostic

Severe congenital neutropenia is a rare hematological disease characterized by a selective decrease in circulating neutrophils, maturation arrest of granulocytic precursors at the promyelocyte stage, and recurrence of infections. A 2-month-old male infant (patient A) and a 14-month-old female child (patient B) were referred to our hospital due to severe neutropenia. Sequencing analysis of ELA2 and HAX1 genes was performed. Two single nucleotide polymorphisms of HAX1 gene were found. They were 5,104T-->G point mutation of exon 1 and 5,474A-->G point mutation of intron 1 in HAX1 gene. The mutation of ELA2 gene was not found. The patient A showed a good response to granulocyte colony-stimulating factor (G-CSF) treatment and the absolute neutrophil count recovered to 1,195/microliter. But the patient B showed a partial response to G-CSF treatment and experienced several episodes of herpetic gingivostomatitis, oral ulcer, acute pharyngotonsillitis and otitis media during follow-up.
Adaptor Proteins, Signal Transducing/genetics ; Bone Marrow/pathology ; Female ; Granulocyte Colony Stimulating Factor, Recombinant/adverse effects/therapeutic use ; Humans ; Infant ; Male ; Neutropenia/congenital/drug therapy/*genetics ; Neutrophils/cytology/pathology ; Oral Ulcer/etiology ; Otitis Media/etiology ; Polymorphism, Single Nucleotide ; Serine Endopeptidases/genetics ; Stomatitis, Herpetic/etiology

BACKGROUND: Automated blood cell analyzers often read leukemic blasts as normal cells. In this study, we evaluated the 5-part differential patterns of blasts using automated analyzers to determine if they can differentiate among blast types. METHODS: Blood samples containing 10% or more blasts were collected from patients with acute leukemia (N=175). The 5-part differential count was conducted using DxH 800 (Beckman Coulter, USA) and XE-2100 analyzers (Sysmex Co., Japan), and the results were compared with manual differential counts, which was used as a reference method. RESULTS: The DxH 800 reported the 5-part white blood cell differential count in 98.9% of the cases. The XE-2100 provided an invalid automated differential count in 72% of the cases. Both analyzers counted most lymphoblasts as lymphocytes and most myeloblasts as monocytes. In 11 cases, the DxH 800 reported a 5-part differential count without a blast flag. CONCLUSIONS: Some automated analyzers are able to recognize and count blasts according to their characteristic cell types. Therefore, complete blood counts obtained automatically can provide valuable data for making provisional decisions regarding the lineage of leukemia cells before further investigation.
Acute Disease ; Automation ; Blood Cell Count/*instrumentation/methods ; Humans ; Leukemia/blood/*diagnosis ; Leukemia, Monocytic, Acute/blood/diagnosis ; Leukemia, Myeloid, Acute/blood/diagnosis ; Leukemia, Promyelocytic, Acute/blood/diagnosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood/diagnosis

BACKGROUND: The fecal occult blood test (FOBT) is presently the only laboratory test for screening a population for colorectal cancer. However, the effectiveness of FOBT to reduce the mortality from colorectal cancer is still controversial. The cytokeratin-19 (CK-19) is highly expresssed in gastrointestinal (GI) epithelium. Therefore, fecal CK-19 excretion could be increased in gastrointestinal diseases. METHODS: We estimated fecal CK-19 using cytokeratin-19 enzyme-linked immunosorbent assay (Roche Diagnostics, Mannheim, Germany) on 53 stool samples from patients with various GI diseases and 100 stool samples from control patients. We conducted a study of rapid fecal CK-19 test using gold immunochromatography developed by DiNonA Research Institute (Seoul, Korea) and the fecal occult blood test (FOBT) on 115 stool samples from patients with various GI diseases and 181 stool samples from control patients. RESULTS: The cutoff value of fecal CK-19 was 408.7 pg/80mg. The sensitivity of the rapid fecal CK-19 kit was 10,000 epithelial cells /ml. The positive rate of rapid fecal CK-19 test was 4.4% in the controls, 83.9% in the thrombotic microangiopathy patients after BMT and it was higher than the positive rate of FOBT (58.1%, P=0.0264). In the overall GI diseases including GI cancers, the sensitivity of rapid fecal CK-19 test was 56.5%, and that of FOBT was 21.7%. The specificity of rapid fecal CK-19 test was 95.6%. CONCLUSIONS: The rapid fecal CK-19 test in conjunction with the FOBT could be a valuable screening method for GI diseases especially for GI inflammation.
Academies and Institutes ; Colorectal Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Epithelium ; Gastrointestinal Diseases ; Humans ; Immunochromatography ; Inflammation ; Keratin-19 ; Mass Screening ; Occult Blood ; Sensitivity and Specificity ; Thrombotic Microangiopathies

BACKGROUND: The fecal occult blood test (FOBT) is presently the only laboratory test for screening a population for colorectal cancer. However, the effectiveness of FOBT to reduce the mortality from colorectal cancer is still controversial. The cytokeratin-19 (CK-19) is highly expresssed in gastrointestinal (GI) epithelium. Therefore, fecal CK-19 excretion could be increased in gastrointestinal diseases. METHODS: We estimated fecal CK-19 using cytokeratin-19 enzyme-linked immunosorbent assay (Roche Diagnostics, Mannheim, Germany) on 53 stool samples from patients with various GI diseases and 100 stool samples from control patients. We conducted a study of rapid fecal CK-19 test using gold immunochromatography developed by DiNonA Research Institute (Seoul, Korea) and the fecal occult blood test (FOBT) on 115 stool samples from patients with various GI diseases and 181 stool samples from control patients. RESULTS: The cutoff value of fecal CK-19 was 408.7 pg/80mg. The sensitivity of the rapid fecal CK-19 kit was 10,000 epithelial cells /ml. The positive rate of rapid fecal CK-19 test was 4.4% in the controls, 83.9% in the thrombotic microangiopathy patients after BMT and it was higher than the positive rate of FOBT (58.1%, P=0.0264). In the overall GI diseases including GI cancers, the sensitivity of rapid fecal CK-19 test was 56.5%, and that of FOBT was 21.7%. The specificity of rapid fecal CK-19 test was 95.6%. CONCLUSIONS: The rapid fecal CK-19 test in conjunction with the FOBT could be a valuable screening method for GI diseases especially for GI inflammation.
Academies and Institutes ; Colorectal Neoplasms ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells ; Epithelium ; Gastrointestinal Diseases ; Humans ; Immunochromatography ; Inflammation ; Keratin-19 ; Mass Screening ; Occult Blood ; Sensitivity and Specificity ; Thrombotic Microangiopathies