The effect of vitamin D3 deficiency on hematological indices in Isfahan patients

Aim: Since suboptimal vitamin D3 levels may be associated with anemia and several disorders, the study presented here investigated hematological indices state at patients with vitamin D3 deficiency. Methods: This cross-sectional study performed in Isfahan, Iran between 2017 and 2019. Initially, patient vitamin D3 level was determined. Based on vitamin D3 reference ranges them were divided into two vitamin D3-deficient (vitamin D3<25ng/mL) and control groups (>25ng/mL). Completed blood count was measured by hematology analyzer. Alkaline phosphatase (ALK) level was also measured and the results were statistically analyzed. Results: Of 1925 studied patients, 621 (32.3%) patients were male and 1274 (67.7%) females. 909 patients have an abnormal levels of vitamin D3 (<25ng/mL) and 1016 patients have sufficient vitamin D3 level. A weak correlation observed between white cell count and mean cell volume and low level of vitamin D3 (beta = 0.11). We also found a significant difference in mean age of patients with vitamin D3-deficient compared to control (p = 0.003). Moreover, we found no significant change in serum ALK levels between patients with vitamin D3 deficiency and control as well as subgroups of vitamin D3 deficiency. Conclusions: Vitamin D3 deficiency may not have significant impact on red cell count and indices, differential white blood cell count, and platelet count. It is suggested that a prospective cohort study be conducted in the future

Irradiation of platelets in transfusion medicine: risk and benefit judgments

Irradiation of platelet products is generally used to prevent transfusion-associated graft-versus-host disease (TA-GvHD) as well as transfusion-transmitted infections. As an essential prerequisite, gamma-irradiation of blood products prior to transfusion is required in patients who may develop TA-GVHD. Most studies suggest that gamma irradiation has no significant effect on the quality of platelet products; however, more recent studies have shown that the oxidative effects of gamma irradiation can lead to the induction of platelet storage lesion (PSL) and to some extent reduce the efficiency of transfused platelets. As the second widely used irradiation technique, UV-illumination was primarily introduced to reduce the growth of infectious agents during platelet storage, with the advantage that this method can also prevent TA-GvHD. However, the induction of oxidative conditions and platelet pre-activation that lead to PSL is more pronounced after UV-based methods of pathogen reduction. Since these lesions are large enough to clearly affect the post-transfusion platelet recovery and survival, more studies are needed to improve the safety and effectiveness of pathogen reduction technologies (PRTs). Therefore, pointing to other benefits of PRTs, such as preventing TA-GvHD or prolonging the shelf life of products by eliminating the possibility of pathogen growth during storage, does not yet seem to justify their widespread use due to above-mentioned effects. Even for gamma-irradiated platelets, some researchers have suggested that due to decreased 1-hour post-transfusion increments and increased risk of platelet refractoriness, their use should be limited to the patients who may develop TA-GVHD. It is noteworthy that due to the effect of X-rays in preventing TA-GvHD, some recent studies are underway to examine its effects on the quality and effectiveness of platelet products and determine whether X-rays can be used as a more appropriate and cost-effective alternative to gamma radiation. The review presented here provides a detailed description about irradiation-based technologies for platelet products, including their applications, mechanistic features, advantages, and disadvantages