Journal du sang et de la lymphe

 Background: We have been investigating serial changes in Type I Interferon (IFN) receptor alpha-2 (IFNAR-2) expression in peripheral blood leukocyte subsets in Chronic Hepatitis C (CHC) patients during IFN-based therapy. The aim of this study was to clarify whether changes in IFNAR-2 expression by peripheral blood leukocyte subsets are predictive factors for Sustained Virological Response (SVR).

Background/Aims: Genetic variation in the interleukin 28B (IL-28B) region has been associated with sustained virological response (SVR) rates in patients with chronic hepatitis C (CHC) who were treated with pegylatedinterferon (PEG-IFN) and ribavirin (RBV). The aim of this study is to clarify whether changes in type 1 IFN receptor 2 (IFNAR-2) expressions by peripheral blood monocytes (Mo) are related to genetic variation near the IL-28B gene.

Patients and Methods: One hundred and forty-eight CHC patients with genotype 1b and high viral load receiving PEG-IFN and RBV were studied. IFNAR-2 expression by peripheral blood Mo was measured as the mean fluorescence intensity (MFI) before and up to 28 days after starting therapy. Eighty-three of 148 patients consented to genetic investigation (IL-28B genetic variants in rs8099917).

Results: There were no significant differences in MFI of peripheral blood Mo between SVR and non-SVR patients during the study period in patients with genotype TT in rs8099917; however, MFI of peripheral blood Mo at days 7 and 14 of treatment was significantly higher in SVR patients than in non-SVR patients with genotype TG in rs8099917.

Conclusions: IFNAR-2 may be related to efficacy of PEG-IFN and RBV in CHC patients possessing poorresponse IL-28B variants.

Predetermined transfusion guidelines, pre transfusion approval, and transfusion audits are useful tools in the education of those ordering blood components, potentially resulting in the reduction of inappropriate use of blood components. In most cases, blood components released based on the demand of the ordering physician, despite the advice of the blood bank physician, were deemed as inappropriate transfusions. The present study was conducted upon 1694 episodes of transfusion units for different blood components over a period of 3 months from November 2011 to January 2012, out of total 1694 transfusion episodes in 920 requests for 796 patients. 124 patients had multiple requests. 208 males and 588 were females. . Single unit requisitions were 456, and two unit requisitions were 354, and 3 or more unit requisition in 110 requests. 222 requests contained >10 gms% as indication, 330 requests had 7.1- 9.9 gms%, and 250 requests with <7 gms%. Elective transfusion requests found in 100 requests and 369 had emergency request, and 451 didn’t contain any information. 136 patients received single unit transfusion. 660 patients had 2 or more than 2 unit transfusion. During this 3 month period 20.3 units /day was bled at blood bank and in camps. 26.4 units/day issued to both IP and OP requests. 18.4 units/day was issued to IP requests. 450 requests from Department of Obstetrics and Gynecology (OBG dept), 735 requests had indication for blood transfusion written in the requisition. This study therefore suggests that prospective audits of blood component orders can help reduce inappropriate transfusions and can be a valuable educational tool for the ordering physicians as well as for residents in training.