ABO-blood typing typically involves both front typing (cell typing) and back typing (serum typing) to ensure accurate determination of blood type. However, in neonates, back typing is frequently omitted due to their immature immune system. If an institution chooses red blood cells (RBCs) that match the neonate's blood type, omitting back typing could lead to unexplained cross-matching incompatibilities. Therefore, blood banks should be cautious with neonatal blood typing and transfusion practices to ensure transfusion safety.

Familial pseudohyperkalemia (FP) is a dominantly inherited condition caused by variants in the gene ABCB6 resulting in red blood cell (RBC) membrane protein defects. FP is generally asymptomatic. However, FP RBCs have an increased permeability to monovalent cations when stored below 37°C. Transfusion of RBC components donated by FP individuals can induce hyperkalemia and may be causally related to transfusion-associated hyperkalemic cardiac arrest, particularly in neonates and infants. Therefore it is necessary to accurately evaluate the frequency of FP occurrence in the Korean population and assess whether FP RBCs have significantly higher supernatant potassium levels. Efforts should be made to recognize the effects of blood products collected from FP donors on blood transfusion recipients to reduce the risk of hyperkalemia, especially in fetuses, infants, and patients at risk of this condition.

Leukoreduction is a process in which the white blood cells (WBCs) in cellular products are intentionally reduced to bring down the risk of adverse transfusion reactions, such as febrile nonhemolytic transfusion reactions or human leukocyte antigen alloimmunization. So far, Korea has not considered leukoreduction of plasma products. However there have been recommendations for leukoreduction to improve patient outcomes. The authors have experience in measuring WBCs and WBC fragment counts in plasma products and have shown that the WBC and their fragments could be efficiently removed using leukoreduction filters. Hence, it may be beneficial to begin discussions on the necessity of using leukoreduction of plasma products.

The diagnostic and treatment methods of multiple myeloma (MM) have been rapidly evolving owing to advances in imaging techniques and new therapeutic agents. Imaging has begun to play an important role in the management of MM, and international guidelines are frequently updated. Since the publication of 2015 International Myeloma Working Group (IMWG) criteria for the diagnosis of MM, whole-body magnetic resonance imaging (MRI) or low-dose whole-body computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography/CT have entered the mainstream as diagnostic and treatment response assessment tools. The 2019 IMWG guidelines also provide imaging recommendations for various clinical settings. Accordingly, radiologists have become a key component of MM management. In this review, we provide an overview of updates in the MM field with an emphasis on imaging modalities.

The diagnostic and treatment methods of multiple myeloma (MM) have been rapidly evolving owing to advances in imaging techniques and new therapeutic agents. Imaging has begun to play an important role in the management of MM, and international guidelines are frequently updated. Since the publication of 2015 International Myeloma Working Group (IMWG) criteria for the diagnosis of MM, whole-body magnetic resonance imaging (MRI) or low-dose whole-body computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography/CT have entered the mainstream as diagnostic and treatment response assessment tools. The 2019 IMWG guidelines also provide imaging recommendations for various clinical settings. Accordingly, radiologists have become a key component of MM management. In this review, we provide an overview of updates in the MM field with an emphasis on imaging modalities.

Background: According to the revision of the Blood Management Act in 2020, medical institutions that meet certain conditions are obliged to install a transfusion management division in Korea. Therefore, this study assessed the management status of the transfusion management division at major medical institutions. Methods: From August 7th to August 18th, 2021, a survey questionnaire was given to laboratory physicians of 10 major medical institutions in Korea, and the installation and operation of the transfusion management division were surveyed. Results: The medical institutions that participated in this survey completed a transfusion management division in the first half of the year. Doctors, nurses, and medical technologists were assigned as medical personnel, and all laboratory physicians were leading the work as the head of the transfusion management division. Regarding the tasks performed at the transfusion management division, all medical institutions conducted a transfusion appropriateness assessment, education related to transfusion, and adverse transfusion reactions. Most medical institutions had difficulties because there was an insufficient basis to calculate the workforce and budget in installing and operating the transfusion management division. Conclusion There are rarely reference materials for the practice and operation of the transfusion management division, which has no precedent in Korea, so it is often difficult for medical institutions to prepare it. This study will be a reference for medical institutions that need to install a transfusion management division in the future.Efforts should be made to legislate transfusion management fees focused on the academic community.

Background: Pretransfusion testing is vital for safe transfusion. However, in situations without time to perform sufficient testing, all or part of the pretransfusion testing may be skipped to issue blood quickly. This study evaluated the safety of red blood cell (RBC) transfusion released by an emergency blood transfusion protocol through retrospective analysis at a tertiary hospital for eight years. Methods: All RBC transfusions following the emergency blood transfusion protocol from 2011 to 2018 at Seoul National University Hospital were included in the study. Crossmatching and unexpected antibody screening test results conducted after RBC release and the occurrence of hemolytic transfusion reactions were analyzed. Results: A total of 1,541 cases (5,299 RBCs issued) of emergency blood transfusion were identified. RBCs were issued after performing the immediate spin crossmatch without an unexpected antibody screening test in most cases (1,443; 93.64%), while RBCs were issued with no pretransfusion testing in 98 cases (6.36%). Antibody screening tests performed after the issue of RBCs showed that 17 (1.1%) cases were positive. Two units of RBCs from two different cases showed positive antiglobulin crossmatch test results. However, none of them were suspected to be associated with a hemolytic transfusion reaction. Conclusion The incidence of incompatible RBC release was very low in patients receiving RBC transfusion through the emergency blood transfusion protocol suggesting it can be used safely with minimal risk of hemolytic transfusion reactions caused by incompatible blood transfusions.

Angiogenesis is important for the proliferation and survival of multiple myeloma (MM) cells. Bone marrow (BM) microvessel density (MVD) is a useful marker of angiogenesis and an increase in MVD can be used as a marker of poor prognosis in MM patients. We developed an automated image analyzer to assess MVD from images of BM biopsies stained with anti-CD34 antibodies using two color models. MVD was calculated by merging images from the red and hue channels after eliminating non-microvessels. The analyzer results were compared with those obtained by two experienced hematopathologists in a blinded manner using the 84 BM samples of MM patients. Manual assessment of the MVD by two hematopathologists yielded mean±SD values of 19.4±11.8 and 20.0±11.8. The analyzer generated a mean±SD of 19.5±11.2. The intraclass correlation coefficient (ICC) and Bland-Altman plot of the MVD results demonstrated very good agreement between the automated image analyzer and both hematopathologists (ICC=0.893 [0.840–0.929] and ICC=0.906 [0.859–0.938]). This automated analyzer can provide time- and labor-saving benefits with more objective results in hematology laboratories.

Para-Bombay phenotypes are rare blood groups that have inherent defects in producing H antigens associated with FUT1 and/or FUT2. We report the first case of para-Bombay blood type in a Southeast Asian patient admitted at a tertiary hospital in Korea. A 23-year-old Indonesian man presented to the hospital with fever and was diagnosed with a disseminated nontuberculous mycobacterium infection and anemia. During blood group typing for blood transfusion, cell typing showed no agglutination with both anti-A and anti-B reagents. Serum typing showed strong reactivity against B cells and trace agglutination pattern with A1 cells. His red blood cells failed to react with anti-H reagents. Direct sequencing of FUT1 and FUT2 revealed a missense variation, c.328G>A (p.Ala110Thr, rs56342683, FUT1*01W.02), and a synonymous variant, c.390C>T (p.Asn130=, rs281377, Se³⁵⁷), respectively. This highlights the need for both forward and reverse grouping.
ABO Blood-Group System ; Agglutination ; Anemia ; Asian Continental Ancestry Group ; B-Lymphocytes ; Blood Group Antigens ; Blood Transfusion ; Erythrocytes ; Fever ; Humans ; Indicators and Reagents ; Korea ; Mycobacterium Infections, Nontuberculous ; Phenotype ; Tertiary Care Centers ; Young Adult

No abstract available.
Humans ; Korea